Two's a Crowd
by ggo85
Summary: Doc Martin is back in Portwenn, and so is the new GP.  Can't we all get along?
1. Chapter 1

**Author's Notes:**

**Although I wish Doc Martin and all that it comprises belonged to me – for so many reasons – it is the property of Buffalo Pictures. I've borrowed DM, LG and the others for this fanfic but promise to put them back in one piece when I'm finished. This work of fanfic is for amusement only and no infringement of any legal rights is intended.**

**This story is rated a strong PG-13 for language and adult themes.**

**I've done my best to incorporate British conventions – if not English spelling. If errors remain, it's an American thing.**

**Finally, a sincere and HUGE thanks – once again – to robspace54 for his beta. His suggestions only made my story better and his encouragement is much appreciated.**

* * *

"So, Martin, what are you going to do?" Joan asked, taking a long sip of coffee before setting the cup and saucer on the chairside table of her living room.

Sitting across from her, Martin leaned against the armrest of the sofa, legs straight in front of him and nursing a glass of mineral water. He'd spent the past several days in London. Until the birth of his son less than a week ago, it was where he'd expected to spend the next few years, if not the rest of his life. How things had changed. Now, given his travels, today was the first time he and his aunt had been able to talk for more than a few minutes.

"What am I going to do about what?" he asked.

"About," Joan flung her arm out, "everything. Where you're going to live, where you're going to work, what you're going to do about Louisa and the baby."

"I already told you that I decided not take the job in London." He'd gone to London as planned, right after Louisa gave birth, but to decline rather than start the job as Chief of Vascular Surgery at Imperial College.

"What reason did you give for your change of heart, if you don't mind my asking?"

He did mind and almost said as much. But this was his Aunty Joan, the closest person he had to a confidante. If anyone deserved an explanation, it was she.

"I told them some personal issues had come up that prevented me from accepting the position."

"Louisa and the baby."

"Among others, yes."

What he couldn't tell Aunty Joan was that, despite all of Edith's efforts – and his own – to conquer his hemophobia, he still found himself nauseated at the sight and smell of blood. For god's sake, he'd vomited at the sight of his own newborn son. If he couldn't look at a baby covered in a bit of bloody mucous without throwing up, he was certainly not going to be able to perform vascular surgery.

It was a realization that dawned on him the moment Louisa and the baby were safely loaded into the ambulance, when he knew he should be on his way to London to begin his new job. And knew equally certainly that he couldn't do it. He could no more perform surgery today than he could on that elderly patient years ago. So, he'd continued on to London, with a different purpose in mind.

The process of backing out of the Chief of Surgery position had been humiliating. Walking into Milligan's office amid a torrent of welcomes and congratulations and leaving . . . well, as Elaine had once said, with his tail between his legs. One didn't simply turn down such a prestigious position, not after having campaigned for weeks to obtain it. Milligan had said all of the right things at their meeting but Martin wondered if his colleague suspected that his blood thing was one of the "personal issues" he'd cited as explanation for his decision. Regardless, Martin knew it would have been more humiliating to have taken the job and then been unable to complete a scheduled surgery or, even worse, to have vomited in the middle of one.

Of course, the hemophobia wasn't the only thing keeping him from a future in London. As Joan had said, there was Louisa and the baby . . . his baby . . . their baby. Standing outside that stupid pub while Louisa was inside in labor, struggling to deliver their child had triggered feelings that he wasn't quite sure he even understood. He only knew that, suddenly, his move to London seemed althogether wrong.

Now, however, sitting in his aunt's living room, he realized he had no earthly idea what he was going to do next. He couldn't sit around here day after day, cooking dinner and tending to chickens. Joan was right; he needed a place to live and a job, if for no other reason than he had a child to support.

"So, if you're not going to London, where _do_ you plan to go?" Joan asked, interrupting his thoughts.

Left unsaid was that he couldn't very well work here. The new GP was due in town this week and a village the size of Portwenn could support only one doctor. There were, of course, plenty of openings for GPs all over the country. If he wanted to stay anywhere near Louisa and the baby, however, his options were much more limited.

"I've made a few inquiries. There may be an opening for a GP in Truro in six months time. Dr. Emerson is said to be retiring."

Joan's eyebrows went up. "In Truro?"

"Where do you expect me to go?" he asked, his voice rising slightly.

"I don't know, Martin. You're the one who made a mess of things here."

"I made a mess of things?" He was almost yelling. "I wasn't the one who disappeared for six months, showed up pregnant and then wanted nothing to do with the child's father."

"No, but you were the one who showed no interest in your own child, who took up with his old girlfriend, and who decided to go back to London without telling anyone until the last possible moment."

Martin was now on his feet. "That's not fair!"

Joan remained seated. "But it is true. Why did you do it, Martin? Was it out of spite? Fear? Something else?"

"What was I supposed to do?"

"Other than take off like a scared rabbit, you mean?" she said dismissively. "Let me see . . . you might have sat down with Louisa, discussed how you could be part of your son's future—"

"I've provided for him financially," he replied indignantly. "Quite well, in fact."

"I'm sure you have, Martin. You'll send her nice little checks so you don't have to dirty your hands a tiny bit."

"I'm taking care of my responsibilities."

"You're taking care of the easy part. There's more to being a father than writing checks. Like being part of your son's life."

"I'm here now."

"Yes, you are." Joan stood up from the chair and walked into the kitchen to refill her coffee. Martin wondered if she'd intentionally tried to ease some of the tension in the room.

"Have you even spoken to Louisa since the baby was born?" she asked when she returned to the room a minute later.

"She only got out of hospital a few days ago and I've been in London most of that time. We've spoken a bit by phone," he added, somewhat defensively.

Martin knew that Joan had been spending a lot of time with Louisa since she'd come home from the hospital, helping her get settled. For all of the friends that Louisa had in Portwenn, there weren't many women she could call on to help with a situation like this. He should be there, of course, to help out. Not that he would be much help given that, other than medical issues, he didn't know the first thing about dealing with babies.

"Have you told her of your decision not to move to London?"

"Not yet. I'm going to see her tomorrow. I'll tell her then."

"Good." Joan eased herself back into the chair took another sip of her coffee. "Did you say that you're looking to be a GP? Have you given up on surgery?"

He couldn't meet her eyes. "For now, yes."

"And you're satisfied with that? Not being a surgeon, that is?"

"Does it matter if I'm satisfied, as you put it?"

Of course, he wasn't happy that he could no longer be a surgeon. As he'd once told Louisa, it was the only thing he was really good at. Nonetheless, he still wanted, needed, to be a doctor and, for now, at least, working as a GP was the best – or maybe only – option. Did that make him "satisfied" with the result?

"Of course it matters."

"To whom?"

"Martin, no one wants to go around being miserable in their job."

"Who said I was miserable?"

"Well, you obviously weren't completely happy or you wouldn't have looked to go back to Edith and to surgery."

He looked away. "Edith is out of the picture."

"And thank goodness for that. So, is she the only reason you wanted to go back to surgery? And to leave Portwenn?"

He stood up quickly and walked to the window, looking out at her farm. "No! Of course not."

"Then I don't understand."

"Oh for god's sake, Aunty Joan, give it a rest. What I do with my life is not your problem."

"You mean it's none of my business."

"That too."

He'd found it relatively easy to dismiss Joan's concerns. However, he still needed to confront Louisa.


	2. Chapter 2

As promised, Martin drove into Portwenn the next morning with plans finally to see Louisa and the baby. He glanced up from where he'd parked at the harbor toward the climbing narrow streets, eyeing people and businesses he hadn't expected to see again, or at least see again for a long while. Grabbing the pile of dirty clothes from the backseat of the Lexus, he took a deep breath and started up the hill.

It wasn't more than a few yards before he encountered his first villager, Mr. Maxwell, an elderly gentleman and former fisherman whom he'd treated over the years for hypertension.

"Well, if it isn't Doc Martin! Thought you was in London."

Martin rolled his eyes. "Obviously not."

"I can see that. What are you doing _here_ when you're supposed to be in London?"

"None of your business," Martin replied. As he pushed past the man, the little dog that had been the bane of his existence for the past year came running up, barking excitedly and trying to nip at his trousers.

"Go away!" How in the world had the dog found him? "Get!"

"Hey, Doc!" Martin stopped trying to shoo away the dog long enough to see who was calling now.

"Heard you were back in town." It was the postman, who always seemed first with every tidbit of local gossip.

Martin thought about simply pretending that he hadn't heard the man.

"So what happened in London?" the postman asked, moving closer. "They send you back already?" he asked with a wicked smile.

"Nothing _happened_ in London," Martin said through clenched teeth.

"If you say so," the postman replied in a tone of disbelief.

Martin merely grunted and continued on to the dry cleaners. He'd assumed he'd be unpacking in London by now and had with him only the clothes he'd packed in a suitcase, which by now all needed a good cleaning.

He dropped the dirty clothes onto the counter as the cleaner sidled up. "Doc, heard you were back in town."

"Hasn't everyone?" he muttered. He parceled out the clothing. "Two suits, four—"

"Why aren't you in London?"

"Four shirts," he repeated harshly. "Heavy starch. I need them tomorrow."

"Things didn't work out there, huh?"

"Why is everyone so interested in my personal business?" He struggled to keep his voice below a shout.

"Well, it's not everyday that our GP decides to go back to surgery in London and then a few days later is right back here—"

Martin grabbed his laundry ticket from the man's hand and stormed out of the building. Three people down, nearly a thousand still to go. Would he be forced to explain himself to every blasted one?

He managed to make it to Louisa's cottage without any more intrusive questions. Her new home was closer to the school but Martin missed the familiarity – and the memories – of White Rose Cottage. Standing outside her door now, he felt like a schoolboy on his first date. He took a few breaths to calm himself, smoothed out his suit, checked that his tie was lined up properly, and made sure that no food particles were lodged in his teeth before knocking gently on the front door.

Louisa answered his knock dressed in a housecoat with a cloth draped over her shoulder and what looked like spittle dribbled down the front. Her hair was disheveled and her face drawn.

Martin could only think how much he'd missed her and asked himself again how he'd ever considered leaving for good.

"Martin!" Louisa's face brightened and her eyes smiled at him. In her arms was the baby, wrapped in a blue blanket. His baby, he kept reminding himself. That baby had half of his DNA, god help him.

"Louisa. Have I come at a bad time?" he asked.

"No, no. Come in. I'm just about to feed him."

He hesitated at the doorway. "Maybe I should come back later."

She opened the door wider with her free hand and motioned him inside. "No, it's all right." She seated herself on the sofa and, after a moment, he took the nearby chair.

"You look tired," he said, eying her critically.

Her eyes flashed. "Thank you, Martin. I am tired, maybe because I haven't had more than three hours of uninterrupted sleep since I left the hospital."

"It's important that you rest."

"And how am I supposed to do that?" She looked down at the child, still content in her arms.

"I told you it wouldn't be easy, doing this on your own."

"Yes, you did. And of course, the great Dr. Ellingham was right as always."

Oh god. He'd been here less than two minutes and already they were arguing. Why did they find it so difficult to conduct a normal conversation? He'd promised himself that he'd try to do a better job of communicating with Louisa and yet he wasn't off to a very good start.

"I'm . . . sorry." There, he'd actually said the word. "I didn't mean . . . it's just that I thought Joan was helping you," he said. "You need to let others help you, Louisa."

"I am, Martin. But the baby is still my responsibility."

He hesitated a brief moment. "Perhaps I can help as well."

Her eyes widened. "You? Help with the baby?"

"Yes. It's not as if I have much to keep me occupied at the moment."

Louisa seemed to relax slightly at the comment. "That would be . . . nice. If you helped, that is." She nodded toward the small bundle in her arms. W"ould you like to hold him?"

Martin just as quickly tensed, but held out his hand. "I can try."

Louisa handed the baby over to him. He did his best to mimic the way she'd held him, supporting his back and cradling his head. The baby – Tommy, she'd named him – well, actually Thomas Norton Glasson – looked much as he had a week ago, only cleaner. The slightly pinched head, caused by his passage through the birth canal was still there, he noted automatically.

"What do you think?" Louisa asked. "Does he look more like you or me?"

He looked into the baby's eyes, now staring up at him. They were the greyish blue color of his own, he realized, and not the vibrant blue of Louisa's. Bad luck there. He reached for the baby's hand, his large fingers easily covering the tiny ones. He wanted to check every inch of this small body, to reassure himself that the child was fully healthy. Yet he couldn't tear his eyes away from Tommy's.

"For his sake, I hope he looks like you." Martin dared not move, fearing he'd cause the baby to start fussing.

"Would you like something to drink?" Louisa asked.

"I'm fine." He remained perfectly still.

"I'll just get myself some water then." She stood up and went to the kitchen. "So you went to London," she called from the other room.

"I went to decline the position there," he said, hoping that might end the conversation. He really didn't want to go through this yet again, not even with Louisa.

"You did what?" She popped her head through the open doorway.

Oh god, not again. "I declined the surgical position."

"You did? Why?"

"As I told you, I realized I was wrong to leave."

Louisa came back into the room, glass in hand. "If you're not taking the job in London, what are you going to do?"

Would people stop asking him that blasted question! "I'm considering a position in Truro. I'm going to talk to Chris Parsons about it tomorrow." The baby started to squirm and he tightened his grip so that the child wouldn't fall onto the floor.

"In Truro?"

"Yes, in Truro. It's somewhat close to . . . here." Tommy was now twisting and starting to fuss. Martin frowned down at him. "What's wrong?" 

"It's all right, he's just hungry." Louisa reached out and gently took Tommy from his arms. She pushed aside her gown and pulled the baby toward her breast.

Martin tried not to stare. "Uh, maybe I should leave."

"Martin, I'm nursing our son. Does that bother you?"

"Uh, no." It was just that, he stayed where he was, he would either be forced to look at Louisa's breasts or pointedly not look at her. He stood up. "I'll just . . . um, get a glass of water."

By the time he returned to the room, the baby seemed to be nursing contentedly. Martin stepped toward the window, trying to figure something that he could talk about that wouldn't provoke another argument.

"It's started to rain," he said. His car was parked several blocks down the street. "And I left my umbrella in the car."

Louisa looked up at him. "You could stay here."

"Until the rain stops, you mean?"

"I meant until you find a place of your own . . . or whatever."

He turned around, making sure he'd heard clearly . . . and that she wasn't joking. "Stay here? With you?" Indefinitely? he asked himself.

Her mouth formed a slight pout. "Is it a bad idea?"

"No, of course not."

"Would you like to stay here?" she asked and Martin thought he heard a note of hope in her tone.

"It would be convenient . . . for now."

"You can sleep in the spare room, if you like. It's a bit small but at least you might not hear the baby crying—"

"It's fine."

"So you want to stay?" 

"If you want me to."

"I do."

"Good."

Louisa returned her focus to the nursing baby, and Martin contemplated what he'd just done. He'd actually agreed to stay with Louisa – to live with her, at least for a while. This was the first time in his adult life he'd agreed to live with anyone. Then again, he was the one who'd told Louisa that he loved her and that he'd been wrong to leave. What better way to prove that, this time, he wouldn't run away from his promises?

After a few minutes, the baby seemed to lose interest in nursing. Louisa settled him into her arms and closed up her top. "Martin, could you burp him so I can take a quick shower?"

"Me?" He was going to be left alone with the baby. Oh god.

"It's not hard, Martin. You just put him against your shoulder and pat his back."

He sighed. He _had_ volunteered and, if he was going to stay here, he was going to have to learn how to help out with Tommy. Best to start now.

"All right, I'll try. But I must warn you that . . ."

"You might want to take off your coat," Louisa said. "He tends to spit up a lot."

He stood up and removed his suit jacket, carefully folding it over the back of the sofa. With some instruction from Louisa, he soon had the baby pressed against him, gently tapping on the child's back.

"You're doing fine, Martin," Louisa assured him. "I'm just going to pop in the shower. I'll be back in ten."

In an instant, he was alone with the baby. He listened for the burps, cringed at the sound of spittle dropping on the towel on his shoulder, and prayed for the ten minutes to pass quickly. It was crazy, he realized, that he was – or had been – comfortable performing delicate surgery on tiny arteries and veins and yet felt totally incompetent burping his own son.

The sight of a freshly scrubbed Louisa coming down the stairs was incredibly welcome and he quickly relinquished Tommy into her arms.

"What do you plan to do when school resumes?" he asked.

"I'll need to hire someone to watch Tommy," she replied. "Do you think Joan might do it?"

"So you still plan to teach?" He'd rather hoped that she'd had a change of heart. Having watched all that Louisa had done for Tommy in the last hour, he couldn't imagine her trying to juggle this and a full-time schedule at school.

"Yes, Martin. I am the head teacher."

He sighed. "I'm aware of that. It's possible that Aunty Joan could do it-"

Before he could finish the sentence, there was a hard, urgent knock on the door.

"Probably someone else wanting to see the baby," Louisa said, standing. "It seems half the village has stopped by already."

"Send them away. God knows what germs they're carrying."

"Martin!"

"I'll deal with them," Martin said. He forcefully opened the door, ready to speak his mind to whomever would make such a racket knowing a newborn was in the home.

To his surprise, the person standing in the doorway was Peter Cronk, drenched and breathing heavily. "Doc! They said you might be here. There's an emergency at the school."

"Peter, I'm no longer the GP."

"I went to the surgery," Peter continued, still slightly breathless. "The new doc wasn't there." The boy's eyes were pleading. "Please. She can't breathe."


	3. Chapter 3

Thunder cracked overhead as he struggled to keep up with Peter on the wet pavement. His dress shoes were no help and trying to juggle the umbrella in one hand and his medical case in another only slowed his progress. In frustration, he closed up the umbrella and allowed himself to get wet.

"Come on!" Peter urged. "Hurry!"

"Who's the patient?" he asked, now panting with effort and thankful that they were running downhill.

"Name's Casey. She moved here from Bristol a couple of weeks ago."

"How old?"

"'Bout my age, I reckon." Which meant about thirteen.

When he'd been the GP, it wasn't unusual for him to be seen rushing through town, medical bag in hand. Now that he was no longer the village doctor, people were clearly surprised to see him and, as he passed by, he couldn't help but overhear their comments.

"That the Doc? Thought he was in London."

"What's he doin' here?"

He ignored them, focusing instead on trying to get more information out of Peter. "What happened to her?"

"A bunch of us were playing football. All of the sudden, she stopped up short – couldn't catch her breath."

"Peter! Slow down."

The boy did as directed and Martin quickly caught up with him.

"I'll see to the girl but I need to you to go to the pharmacy. Ask Mrs. Tishell to give you an albuterol inhaler. Can you remember that? An albuterol inhaler."

"Al-but-ter-ol." He nodded. "I'll remember."

"Bring it to me as quickly at the field as possible. And have Mrs. Tishell phone for an ambulance."

Martin was gambling on his diagnosis, but it seemed the most logical explanation. He damned the fact that his medical bag was largely empty. He'd retained a few basic supplies out of habit but, figuring he wouldn't be making house calls in London and a bag full of medicine in the city was asking for trouble, he'd dumped most of his supplies before he'd left Portwenn. One of the many things he'd left behind was an inhaler.

He pushed through the school gate and headed toward the athletic field, where a group of teens clustered around a young woman, on her knees and gasping for breath.

"Out of the way!" he called, pushing through the small crowd to reach her.

"Doc, what are you doing here?" one of the boys asked. "Thought you were in London."

"Obviously not," he replied, dropping his bag and handing the umbrella to the boy who'd spoken. "Hold this over her."

He then turned his attention to the girl, who was panting and trying to suck in air. "I'm Doctor Ellingham. I'm going to take care of you. Can you speak? What's your name?"

"Ca—" It was clearly an effort for her to get the single word. "Casey."

"All right, Casey. Let's sit you down." He turned to one of the boys. "Take off your shirt." He pointed to another. "You, give me a hand."

He put the shirt on the wet grass and eased the girl onto it into a sitting position, the umbrella held overhead giving some respite from the rain.

"All right, the rest of you stand back. Go on." He knelt down on the grass, feeling the water seep through the knees of his trousers, then opened his case and pulled out his stethoscope. Lifting up the back of the girl's shirt, he listened to her lungs, frowning at the sound of pronounced wheezing. He pulled the stethoscope from his ears and pressed his face close to hers.

"Casey, I'm going to ask you some questions. Don't speak. Just nod or shake your head. Do you suffer from asthma?"

A nod.

"Do you have an inhaler?"

"I –"

"Don't speak. Nod or shake your head."

She nodded again.

"Do you have it here?"

She shook her head. "Home."

"All right. We'll have one here shortly. In the meantime, I need you to breathe very slowly. Do you understand me? Breathe as slowly as you can. In and out very slowly."

Martin wiped the water from his face and cursed in frustration. All of the skill in the world would do nothing for this girl unless he could give her the proper medication. Why hadn't he simply kept his bag supplied for another few days? And where was Peter with that inhaler?

Casey was having increased difficulty in breathing and, unless he did something quickly, she'd become cyanotic. As he considered his options, he was vaguely aware of someone running towards them.

"Casey! Oh my god! What happened?"

He looked up and saw a woman standing over them, eyes fresh with worry.

"Who are you?" he asked.

"Her mother. Elizabeth Storm. Are you the GP?"

"I'm a doctor. She's suffering an acute asthma attack. Do you have her inhaler?"

The mother shook her head. "It's at home. I can go get it," she added.

Martin shook his head. "No time." He rummaged through is bag to see what he did have. Adrenaline. Thirty years ago, it had been the drug of choice for acute asthma attacks but had long since been replaced with albuterol. At the moment, he had a patient in crisis whose condition was worsening and no albuterol. He pulled out a syringe and the vial of drug.

"All right, Casey, I'm going to give you an injection. It'll help you breathe."

"What is it?" Mrs. Storm asked.

"Adrenaline – Epinephrine." Calm hands drew the medicine into the syringe. He rubbed the inside of her forearm with an alcohol swab. "Little stick," he said, as he pushed the drug sub-cutaneously.

Within a few seconds, the girl started to breathe easier. He again checked her lungs with his stethoscope, relaxing slightly as he heard a smoother air exchange and a slowing heart rate. "That's better."

"Is she all right?" the mother asked.

Martin sat back on his heels, feeling the water dripping down his back. "Yes."

By the time Peter came running towards them a few minutes later, Casey was breathing almost normally. "Here you go," the boy said breathlessly, handing over the inhaler. "And the ambulance is on its way."

"Thank you, Peter." Martin checked the girl again. For now, she was stable; the inhaler was no longer necessary.

"Does she really need to go to hospital?" the mother asked.

"I'd advise it, just to be sure. And, in the future, she needs to carry her inhaler with her at all times."

"Yes, you're right. We keep telling her . . . " The mother shook her head in frustration. "In any event, I can't thank you enough, Doctor . . . I'm sorry, I didn't catch your name."

"Doctor Ellingham."

"You're not the GP?"

"No. I'm a consultant in Truro."

They were still awaiting the ambulance when a man dressed in jeans and carrying a backpack ran up to them. Martin wondered if it was the girl's father.

"They said there was an emergency," he said, stopping next to them and dropping his bag onto the grass. "I'm Geoffrey Owens, the GP."

Martin looked up with a start and raised his eyebrows. The man looked to be in his early thirties, lanky with a narrow face, fine features, and curly black hair. The circular, wire-rimmed glasses, faded jeans, and wool sweater gave him the look of a young college professor who wrote boring articles and lectured under the trees.

"I got here as quickly as I could," Owens said, surveying the situation. His eyes narrowed. "But I see things seem to be well in hand."

Martin stood up. "Martin Ellingham."

"The old GP. I heard you were back in town."

"They called me when they couldn't find you," Martin explained.

"I'd gone to Truro to get some supplies and just now got back," Owens said. "I'm glad you were here. So what have we got?"

"Thirteen-year-old girl with acute asthma attack. She didn't have her inhaler and I didn't have albuterol so I gave her 0.5 cc one-to-ten thousand epinephrine sub-Q, which as you can see, has resolved her symptoms. We now have an inhaler." He handed it to Owens. "And the ambulance is on its way."

Owens nodded. "Good. Well, thank you again for your assistance. I can take it from here." He knelt down next to Casey and reached for her pulse.

"Right." Martin repacked his bag and started to move away from the scene.

Mrs. Storm stopped him with a hand to his arm. "Thank you again, Doctor. I don't know what would have happened if you hadn't been here."

"She would have died." As he walked away from the scene, he heard the sirens of the approaching ambulance. He didn't look back.


	4. Chapter 4

**Author's Note: I am NOT spoiled re Series 5 and would like to keep it that way. Thus, if there are any similarities between this story (and any future DM stories of mine) and the spoilers that are out there, it's pure coincidence. If they diverge dramatically, so much the better! Finally, if you notice any commonality between what I write and what is planned for S5, please don't tell me so I can remain unspoiled. :)**

* * *

"Martin, there are times when I honestly don't understand you." Chris Parsons looked across the restaurant table at him, a perplexed expression clouding his face.

"How so?" Martin asked innocently. He'd telephone Parsons about his change in plans and asked for a meeting to discuss what he might do professionally now that he'd turned down the surgical position in London. Not only was Parsons a friend but, as head of the local PCT, someone with a pulse on the job opportunities that existed in this region.

"When you left London the first time," Parsons said, "of all the places in the world where you could work as a GP, you chose sleepy, bodmin Portwenn. Not that I'm complaining, of course."

Martin started to interrupt, but Parsons raised a hand to stop him. "No, it was your question, so let me finish. Against all odds, you actually made a go of it. And, as it turned out, you're as brilliant a GP as you were a surgeon."

Inwardly, Martin was pleased at the compliment but kept his mouth shut. Parsons clearly wasn't done.

"Then, suddenly you decide to return to surgery in London. Now you tell me that you quit that before you even got started. You have to admit it's a bit odd even for you . . . especially for you."

"I just couldn't do it," Martin said.

Parsons narrowed his eyes. "Those are the exact words you used when you stopped performing surgery. What happened this time?"

Martin didn't want to explain it again, even to Parsons. "It's complicated."

Parsons took a sip of his bitters. "I have time."

"I'd rather not discuss it."

"Martin, you're one of the finest doctors I know. However, right now, you're also one without a job. I can't help you if you're not honest with me."

Chris Parsons was probably the closest thing to a friend that Martin had. When he'd first developed his hemophobia, most of his colleagues had responded with pity or ridicule. It was Parsons who not only prodded Martin to retrain as a GP, but helped get him the job in Portwenn. And, when Martin had worried it would never work and nearly left after the first day, Parsons had been there to offer encouragement. More importantly, if Martin were to have any chance of finding another position in the area, he needed Parsons' support.

"I thought I'd dealt with my . . . blood issue."

Parsons raised an eyebrow. "But . . .?"

"I vomited when my son was born."

"Oh." Parsons nodded thoughtfully. "I see how that could present a problem." He took off his glasses and carefully cleaned them with his handkerchief. "Maybe you simply need more time to . . . adjust."

Martin sighed. "That's not all."

The waiter brought their food to the table – chicken for Parsons and salad for Martin.

"What else?" Parsons asked once the server had moved away.

"Louisa and the baby. She's the head teacher and has no one else to help her."

"Martin, there's no need to apologize for wanting to be close to your child and his mother. It's normal."

It was normal, Martin thought, if the child's mother wanted you to be a part of his life. He'd always assumed – wrongly it turned out – that Louisa wanted no such thing. The revelation that she did want him to be involved had forced him to change his outlook and reconsider his future plans.

"She's asked me to stay with her," he said, carefully watching for Parsons' reaction.

"Are you going to?"

"Until I find a place of my own.

Parsons smiled broadly. "That's good."

"I'm not so sure."

"I am." Parsons sliced off a piece of chicken. "So you have a place to live but what are you going to do for work? Or should I ask, what do you want to do?"

"I want to work, obviously."

"You need to work," Parsons corrected. "Not financially, probably. But I can't see you sitting around fixing formula and changing nappies all day."

Martin cringed inwardly at the thought.

"Not to mention," Parsons added, "that your patients need you."

"They may take a different view," Martin replied drily.

"Well," Parsons said between bites, "I wish we hadn't filled your old job so quickly. Have you met Owens?"

"In passing."

"He's not you but he has some skills. Was in a group practice in Bristol but wanted to move to a smaller village to start a family." He grinned. "Best we could get on short-notice when you left us high and dry."

"I didn't leave you high and dry," Martin replied indignantly. "I gave you more than sufficient notice—"

Parsons waived his napkin. "A joke, Martin."

"Right." Martin stabbed a piece of lettuce with his fork. "I hear there may be an opening for a GP in Truro in a few months time."

"Yes, Emerson's looking to retire. But are you sure you want to go back to being a GP? In a few months, you might well be able to return to surgery."

It was a fair point. With proper therapy, he might yet overcome the phobia that had forced him into general practice where much of what he was called upon to do was, quite frankly, beneath his skills. Surgery – especially vascular surgery – required exquisite precision, life and death decisions, skilled hands and an even more skilled mind. While being a GP had its challenges, he'd come to resent many of his patients and their boring, monotonous medical ailments. Even so, unless or until he could fully conquer his hemophobia, working as a GP was his only realistic option.

"For now, it's best I stay as a GP."

Parsons shrugged and took another bite of his meal. "Okay. I'll see what I can do about lining you up for the slot in Truro. But we still need to find you something to do for the next few months. Have you considered working as a consultant?"

Martin paused in mid-bite. "A consultant?"

"Your diagnostic skills are first-rate and the hospital could use a good consultant in internal medicine a few days a week. Plus, it would give you a chance to meet some of people there – that will make your application for the GP spot much easier."

Although Martin had his doubts about the last point, the rest of what Parsons had suggested made sense. He needed to work and right now his options were limited. Truro was a bit of a drive but he could probably let a room a few days a week if necessary.

"All right," he said.

"Does that mean yes?"

Martin wiped his mouth with his napkin. "Yes."


	5. Chapter 5

The instant Martin and Louisa entered the restaurant, all eyes turned toward them and there was a noticeable buzz. Martin realized he shouldn't be surprised; it was the first time the two of them had been out in public together since he'd left for London and, in fact, the first time they'd been seen together as a couple in . . . a long time.

Martin had finally convinced Louisa to get out of the house for a few hours and enjoy a decent meal. The Crab was close by and service would be quick. Even so, Louisa was nervous about leaving the baby alone for the first time, even with Aunty Joan.

"She has both of our mobile numbers," he'd reassured her. "And we're only five minutes away."

Inside the restaurant, Martin pointedly ignored the stares and pushed through to a table for two near the back of the restaurant. Almost immediately, the server approached. Martin couldn't recall the young woman's name but remembered having seen her as a patient about a year ago for influenza.

"Doc! Louisa!" she exclaimed. "It's so good to see you. How's the baby?"

Louisa smiled warmly. "Hello, Marissa. He's doing fine. Eating a lot, of course."

"And probably not sleeping very much."

"Not yet."

"You'll have to bring him with you next time. Everyone wants to see him."

Martin had had enough of the chit chat. "Drink order," he demanded, earning an eye roll from the waitress and a stern glance of warning from Louisa.

"I'm glad you made me come," Louisa said to him once they'd placed their orders. "It feels good to have an excuse dress in real clothes and fix my hair."

He always noticed but almost never said anything. It was one of the things he needed to work on. "You look very nice."

"Why, thank you, Martin."

"You're welcome." He smiled inwardly, pleased that he'd finally managed to say the right thing to her. He's almost made a comment about the amount of weight she'd already lost but something told him to hold off and now he was glad that he had.

In the distance, a small crowd gathered around the bar, talking animatedly. Their voices were loud enough that, even from his seat more than a dozen feet away, Martin could make out much of their conversation.

"Saw the new doc yesterday," someone said. "For my bronchitis."

"What's he like?"

"He's a friendly sort. Asked me all about my family and such."

"Well, that's a refreshing change."

"He wrote me a refill and I didn't even have to go into the surgery," an older woman added. "But if he's as nice as you say, maybe I should go in and see him, just to say hello."

"Well, I think he's a bit young."

"He's not that young. At least thirty, I'd say."

"That's young far as I'm concerned," someone added.

"He's kind of hot."

"Leslie, he's married."

"And your point is?"

"At least he doesn't insult his patients."

"Or tell us to shut up."

Martin frowned and started to push back from the table when he felt Louisa's hand cover his.

"Relax, Martin. It's all right.." she said softly. "You know how they are with someone new. Remember how it was when you started."

"I don't have to sit here and listen to this."

"Let them talk. Talk won't hurt you."

He gave her an annoyed look. "I'm not one of your schoolchildren, Louisa."

"Of course not. But you know that they're going to talk about the new GP and compare him to you. It's what they do here. Besides, it won't last forever; they'll move on to something else." She smiled up at him. "Let's not let them ruin our evening."

"Speaking of a ruined evening . . ." Martin groaned at the sight of PC Penhale in civilian clothes approaching their table and felt Louisa's hand squeeze his even harder.

"Hello, Doc. Couldn't stay away from us for long, huh?"

"I'm here, yes."

"But you're not the Doc anymore or at least not our Doc." Penhale deposited his ale on their table and leaned in close. "Have you met the new GP?"

"Yes, I have."

"So what'd you think?"

"About what?"

"The new Doc, of course."

Martin swung his head around. "I'm sure there are more than enough opinions in this room."

"So you're not saying, is that it?"

"That's it." Martin fought to control his frustration. He was beginning to wonder if coming back to Portwenn had been a huge mistake.

"Professional courtesy and all that, right?" Penhale winked.

"All that."

No sooner had a disappointed Penhale returned to the bar than their waitress returned with water for Martin and orange juice for Louisa. Now that the waitress was framed in the room's lights, something caught Martin's attention. He stared closely at the her face as she put down the drinks and took their orders.

"Martin," Louisa said, when she'd departed, "why were you staring at her face? Does she have acute glaucoma too?" she asked with a smile.

"No," he said, now distracted, "something else. Maybe."

"Which the new GP can deal with." She took a deep breath and looked around the room meaningfully. "It's so good to be out of the house," Louisa said in what Martin realized was an obvious attempt to change the subject. "And not have to cook."

"I'm glad you're enjoying yourself."

Louisa checked her watch. "I should telephone Joan to see how she's getting on."

They'd been gone for less than an hour. "I'm sure she would have phoned us if she had any problems."

"Even so . . . I'll just go outside and give her a quick call."

Martin waved her away and sipped his water. A minute later, he turned around at the sound of a commotion at the bar.

"Well if it isn't the new Doc," Penhale's voice rang out loudly. "Can I buy you a pint?"

Martin watched Owens allow his glass to be filled then worked his way through the crowd, ale in hand.

"I'm sorry, I didn't catch your name," Owens said to one of the standees at the bar. "David Wilson? Oh, Williams. Sorry, it's rather loud in here. So, where do you work, David? May I call you David?"

"And you must be Mrs. Tillman," he overheard Owens say. "You and your husband own the flower shop, right?"

"Yes, we do," the woman responded. "You must stop in. We have some beautiful arrangements for your office. Or for your lovely wife."

Martin was momentarily distracted by the waitress bringing their dinner plates.

"I'll be sure to stop in this week," Owens said. "Some flowers would definitely brighten up things."

Where in god's name was Louisa? Martin wasn't sure he could stand another minute of this sanctimonious crap.

As if in answer to a prayer, Louisa returned to her seat. "Tommy's fine. Joan just put him down so we should have a little bit of time."

"Good."

"Oh, there you are!"

Martin looked up to see Owens approaching their table. Good god, couldn't he and Louisa at least eat dinner in peace?

"Joe Penhale said you were here," Owens continued. "And this must be the lovely Louisa. Congratulations on your baby; he's the talk of the village."

"Why, thank you," Louisa said and Martin could have sworn that she blushed.

Owens turned back to Martin. "The word is you're not going to London after all."

"No."

Owens frowned. "So, are you planning to stay here in Portwenn?"

"I'm not sure my plans are any of your business," he said and felt Louisa kick him under the table.

"Well, I just figured if we were going to be in the same town—"

"You're the GP. I'm just staying with Louisa for a short while."

"To be with the baby," Louisa added.

"The folks here have some great things to say about you."

Martin tried to decide whether the man was being serious or only ingratiating. "I'm sure they do," he finally replied, tucking a note of sarcasm into his answer.

"Tough shoes to fill."

"Hmm," he muttered in a manner designed to discourage further conversation on this topic, or any other.

"Well, I'll let you get on with your dinner. Nice to meet you, Louisa."

"Obnoxious twit," Martin said when Owens was outside of hearing distance.

"Martin, he seems nice enough."

"I'm sure he is." He pointed to her largely untouched plate. "Eat up. You need to keep up your strength."

They managed to finish their meal without further interruption. When the waitress returned to clear the table, Martin again found himself staring at her face.

"Martin, what is it?" Louisa asked when she'd gone to get their check. "You keep staring at her."

"Did you notice the rash on her cheeks and nose? – it looks like a butterfly."

She shook her head. "Not really."

"Even in this light, it's obvious."

"Lots of people have rashes."

"Not like this. She may have a serious medical problem."

"And, it's no longer _your_ problem. If whatever she may have bothers her, she can see Dr. Owens."

"I know that." His voice was tight. How could he explain to her that this was something he couldn't ignore, especially when he wasn't sure Owens would pick up on the diagnosis? "But she may not realize her condition and, if what I suspect is true, delaying treatment isn't wise."

"You need to let the new doctor do his job."

The waitress approached and handed them the bill. Martin pulled out his credit card and handed it to her. "Are you tired a lot?" he asked as she swiped his card in her hand-held machine.

She shrugged. "Isn't everyone?"

"No. What about muscle aches? Do you have those?"

She gave him an odd look. "Yeah, sometimes."

"Do you have pain in your joints – your wrists, knees, or fingers?"

"Yes – I thought it was too much exercise." She was now staring at him strangely and Martin noticed that a few of the patrons were now obseriving his inquisition.

"Does sunlight bother you?"

"Why the twenty questions?"

"Just answer."

"Martin!" This time it was Louisa.

He ignored her. "Does sunlight bother you?"

"Yes. Is that a problem?"

"You need to make an appointment with the GP. Immediately."

"Why?"

Martin sighed. "You have a disease called systemic lupus erythematosous, which means you need to get treatment right away."

"What's going on here?" Owens was now at their side, clearly confused as to what was going on.

Martin nodded at the waitress. "She has SLE."

"What?" Owens asked.

He grabbed the waitress' chin and pulled it toward Owens. "Notice the characteristic butterfly rash on her nose and cheek."

"You're diagnosing SLE based on a rash?"

"How would you diagnose it?"

"I'd examine her, run an ANA panel, CBC, chest x-ray—"

"So do it."

"Wait just a minute. I know you _were_ the GP here, Doctor, but it's my job now. And I don't need you to tell me how to do it."

By now, their discussion had attracted the attention of most of the customers. Martin felt Louisa's hand on his arm.

"Martin," she whispered, "let's go."

He looked between the waitress, obviously bewildered, and Owens, equally obviously annoyed.

"Then do your job," he said. "And," he directed his comments to the waitress, "go see him. Tomorrow."

He took Louisa by the arm and escorted her past Owens, past the gawking customers and out of the restaurant.


	6. Chapter 6

There were worse things in the world than changing diapers – but not many – Martin thought as he pressed the Velcro into place on Tommy's nappie. Louisa had said that you got used to it, and maybe in time he would. He'd always been sensitive to offensive odors and the fact that these were coming from his son didn't make them any less offensive. After only a week of experiencing the process, and with a tiny baby at that, Martin couldn't imagine doing it for another three years.

According to Louisa, he was a "natural," but he wondered if the compliment was merely her way of ensuring he did his fair share of the changings in the week he'd been staying with her.

Louisa entered the room, a tiny blue outfit in hand. "What do you think?" she asked, waving it in front of him.

He looked up from his task. "About what?"

"Tommy's going for his first wellness visit today with Dr. Owens. I think he should wear this. What do you think?"

"He'll be naked for the examination," Martin replied. It was a little strange to think of Louisa and his son seeing another GP. However, he had to admit that it made sense. It wasn't good medical practice for Martin to be his son's regular physician.

"I know that," she replied. But he has to wear something to and from."

"I'm sure what you've chosen will be fine."

Louisa put one hand on her hip. "You don't care, do you?"

Martin didn't understand why it mattered what a baby wore to and from the surgery. The only thing that he cared about was the baby's health. And, he'd been sure to keep tabs on that; Tommy was perfectly healthy. Since he was confident of Owens' findings, the clothing the baby wore wasn't important.

"I'm not an expert on baby . . . fashion."

"Are you sure you don't want to come with us?" Louisa asked as she pulled a little blue and white striped shirt over Tommy's head.

"Yes, I'm sure." Martin couldn't imagine himself visiting the new GP's office unless he was this side of dying. It wasn't that he didn't trust Owens; from what Parsons had said, the man was competent. He just couldn't picture himself as a visitor in his former office.

"Dr. Owens will think you don't like him."

"I can live with that." 

"You _don't_ like him, do you?"

"Why does it matter to everyone whether I like him?"

Two hours later, Martin was nearly in a fit. By his reckoning, the visit to the surgery and Louisa's walk to and from should have taken no more than an hour. Had Owens found something wrong? Martin didn't think he'd missed anything but maybe he was too personally involved. Maybe there was a medical problem and that scared him. He was beginning to wish he'd accompanied Louisa if only to ensure that he learned firsthand about any medical issues.

In the time since she'd left, he'd cleaned up the house, prepared dinner, and was now trying to concentrate on the latest issue of the _British Medical Journal_. However, he'd found himself reading the same paragraph over and over, thinking more about Louisa and Tommy than the latest developments in internal medicine.

Finally, he heard a rustling at the door that signaled Louisa's return. He tossed aside the journal, jumped up and raced to the door. "What's wrong?" he asked, looking down at his son, sleeping peacefully in his stroller.

Louisa gave him a strange look. "What do you mean?"

"You've been gone nearly two hours. Did Owens find something wrong with the baby?"

"No. He said Tommy's fine. We stopped to pick up a few supplies at the market."

Martin let loose a deep breath and helped her maneuver the stroller into the house. "Did Owens measure his weight and length?"

"Yes, Martin. He's in the 80th percentile."

Not surprising, Martin thought, given his own size and especially welcome after a premature birth. "Did he check vision and hearing?"

"Yes," she said, unloosening the straps holding Tommy. "He said they were both normal."

"Did he inquire about his sleeping and eating habits?"

"Yes. And about his peeing and pooping."

"Good." Martin relaxed a bit with the realization that Owens had been reasonably thorough.

"If you want to know everything that happened, Martin, maybe you should come with us next time."

"Right." That wasn't likely. "And what about you?"

She glanced up at him. "What about me?"

"Did you tell Owens about your fatigue?"

Louisa pulled Tommy out of the stroller and hugged him close. "All new mothers are tired, aren't they Tommy?"

"Louisa, you've been extremely tired the past few days. Did you mention that your breasts are sore?" It was something he'd noticed the past few nights, when he'd slipped into her bed and hugged her tightly.

"Martin!" Her eyes woidened.

"Well, it's true."

"It's not that bad. Besides, I've read that it's common when you're first nursing."

"Yes, it's called engorgement. But that happens in the first few days after childbirth, not this late."

"I appreciate that you're . . . concerned about my health. But—"

"Of course I'm concerned," he replied irritably. "I'm . . . I was your doctor." He softened his voice. "And I . . . care about you."

She smiled at that. "I know you do, Martin and it's very sweet. But I'm fine, really. If anything gets worse, I'll call Owens. Now, let me change Tommy and put him down."

"Would you like me to do it so you can rest?"

"No, it's all right."

When she came back downstairs a short time later, Martin motioned for her to sit next to him on the sofa. He put his arm around her shoulder and pulled her close. It felt good – he'd missed this over the past nine months; now was the time to catch up.

"I'm glad everything went well today," he said, gently stroking her hair, feeling her body sink into his.

"I must admit that it was a bit odd . . . you know, going to the surgery and not having you there." He didn't reply as he ran her hand along his thigh. "Did you know Pauline left?" she asked.

Martin lifted his eyebrows in surprise. "No."

"Poppy's filling in for now. She said Pauline's gone to nursing school."

"That's almost frightening."

Louisa rested her head against his shoulder. "He's repainted."

"Who?"

"Owens. He's repainted the surgery on the inside. And rearranged the furniture."

"I'd expect he'd want to do things his own way."

"Still, it's weird seeing it look so different."

"Let's forget about him for now. You sit here and rest, while I prepare supper."

She squeezed his leg, causing a slight shudder to run through his body. "Can we sit here a few more minutes like this?"

He gently stroked her arm and gave her a smile. "Yes. Yes, we can."


	7. Chapter 7

It was nearly midnight when Martin finally slipped into the house. He peeked into Louisa's room, found her and the baby asleep, and quietly made his way to the spare bedroom. It had been a long week and his first time away from Louisa and Tommy since he'd moved in with them. The experience had been lonelier than he'd expected.

He'd spent the last three days in Truro, doing all the things that the hospital deemed necessary for him to start work as a consultant. The week began with a series of meetings with heads of departments, his soon-to-be colleagues, and even the hospital administrator. There'd been a few questions about his decision not to take the position in London but the explanation of wanting to be closer to his son quickly ended those conversations.

He was tasked with completing endless forms – from those attesting to his medical qualifications to life insurance policies. Finally, he was required to take certain hospital-mandated training, almost all of which he considered useless and unnecessary. At the end of it, he'd yet to see a single patient but was now apparently considered qualified to do so.

The initial contract was for him to work as a medical consultant in the clinic three days per week. The hours and the pay were less than he'd hoped for but, as Parsons had pointed out, the situation was only temporary until the GP position opened up in a few months.

Driving back along the winding roads that night had left him exhausted and now he quickly brushed his teeth, tugged on his bedclothes, and crawled beneath the crisp sheets. Within minutes, he found himself succumbing to the pull of sleep.

They were at the beach at Newquay. He and Louisa were sitting on a blanket on the sand, watching surfers in the distance. Tommy lay next to them, on his back, giggling contentedly and occasionally playing with his toes.

"Did you see that?" Louisa exclaimed as one of the surfers rode out a long wave. "That's amazing." She looked at him. "Have you ever tried surfing?"

"No."

"We could take lessons sometime, although you'd need to wear a suit."

"I always wear a suit," he said.

She laughed. "I meant a bathing suit."

"All right, if it would please you."

"You really mean it? You'd take surfing lessons with me?"

"Yes, Louisa, for you I'd do it."

"This is nice," Louisa said, leaning back on her elbows.

"Yes, it is." He lay down next to her and intertwined his hand in hers. As always, the contact made him tingle with anticipation.

"We should come here more often," she said contentedly.

"Spending too much time in the sun is harmful. It increases your risk of developing melanoma—"

"And it's hot."

He frowned. "What?"

"Martin, it's hot."

"Of course it's hot. We're at the beach in the sun. It's supposed to be hot."

"Martin." Louisa touched his shoulder.

"What?"

"I'm hot, Martin. Please wake up."

His eyes shot open and he sat up in the bed. A glance at the bedside clock showed it was 0213. He immediately realized that he was in Louisa's spare room, not at the beach, and Louisa was standing next to the bed in her nightclothes. Martin was instantly alert, a skill he'd honed through long nights of surgical call.

"Louisa? What is it?"

"I'm sorry to wake you, Martin, but I feel so hot. And," she bit on her lower lip and looked away, "my breast . . . it really hurts."

"Come closer." When she did so, he pressed the back of his hand to her forehead and immediately frowned. She was running a temperature of several degrees. Damn.

"Go back to your bed while I get my bag."

Martin pulled on his dressing gown, washed his hands, retrieved his bag from downstairs, and was sitting on the edge of Louisa's bed in less than two minutes.

He placed the tympanic thermometer in her ear and checked the result. "102.3," he reported. "No wonder you feel feverish." A quick check of her pulse found it nearly normal. "You said your breast was sore. Both or only one?"

"Just the right one." She shrugged slightly. "I thought it was, you know, sore because of the nursing. But it's been getting worse."

"Did you call Owens?"

"I called the surgery today and talked to Poppy."

"Poppy? Since when is she qualified to provide medical advice?"

"She passed along my message. She said that Owens felt it was probably nothing serious but that, if I didn't feel better in 48 hours I should come in to the surgery."

Martin harrumphed. "So, he dispensed medical advice through an unqualified receptionist without even speaking to the patient."

"I didn't feel that bad when I called. I'm sure if I'd made it sound more serious—"

"All right, let me see." He motioned for her to remove her nightshirt.

She hesitated. "Martin, I—"

"Louisa, if I'm to help, I need to examine you." He struggled to control his frustration at her newfound sense of modesty. For god's sake, he was a doctor.

She met his eyes for a minute, then gingerly lifted her nightshirt over her head.

Martin evaluated the affected breast with a clinical eye. Any other time, the sight of Louisa in her bed half-naked would have been more than titillating. Knowing Louisa was sick and in pain, he pushed aside any such thoughts and focused all of his attention on his clinical skills.

There was a characteristic wedge-shaped area of redness in the upper right quadrant of the breast. He gently pressed the tips of his fingers against the skin, finding it warm to the touch.

She jerked away. "Ow! Martin, that hurts."

He grimaced. "I'm sorry, Louisa. I think the inflammation and soreness is being caused by mastitis but I need to make sure there's no abscess."

"Mastitis?"

"An inflammation of the breast tissue common in nursing mothers," he explained. "It's painful, but not serious." He tried to be as gentle as possible, not meeting Louisa's eyes, as he continued his palpation of the affected breast. Next, he checked her left side, finding it reassuringly normal.

"That's all. Here you go." He handed her back the nightshirt and helped her put it on.

"Martin." Louisa's voice was sultry as her hand reached out for his arm.

He felt her fingers tracing softly along his forearm, sending ripples of pleasure through his body. He tried to forget they were sitting inches from each other, her hormones racing and his . . .

Good god. He was acting like a schoolboy – irrational, not to mention unprofessional. He shook off the feelings that surged within him, sat up straighter, cleared his throat and reminded himself that he was a doctor – Louisa's doctor.

"It's mastitis," he repeated in a detached, professional tone. "But there's no sign of abscess, which is good."

"How did I get it?"

"Most likely bacteria from the baby's mouth entered the breast tissue through a crack in the skin." He sought comfort in the familiarity of the medical explanation. "That in turn caused an infection which caused the pain and swelling as well as the fever and fatigue."

"Do I have to stop breastfeeding?"

He shook his head. "No, in fact it's very important for you to continue breastfeeding in order to remove the milk from the breast. I'll give you antibiotics to treat the infection; I'll get some from Mrs. Tishell in the morning. Don't worry, it's perfectly safe for the baby. In the meantime, we'll try some paracetamol for the pain along with some warm compresses. Most of all, it's important for you to rest."

Louisa's eyes were moist. "What did I do wrong?"

He cupped his hand under her jaw and gently lifted her head until she was looking directly at him. "Louisa," he said softly, "you've done nothing wrong. You have a minor infection that will clear up very quickly with rest and antibiotics."

"I'm a failure as a mother. I can't even breastfeed my own son."

Martin sighed. Louisa was ill and obviously somewhat depressed; she wasn't thinking or talking clearly. Probably hormonal imbalance as well. Being short with her wouldn't help.

"You're a fine mother – Tommy couldn't ask for better and neither could I."

She gazed up with him. "Do you mean that?"

He pushed up against her and brushed his lips against hers. "Of course I do."

"Ow." She involuntarily shrank away from the pain of his chest touching hers. "Oh, Martin. I'm sorry, I didn't mean—"

Once again, Martin scolded himself. Right now, he needed to be Louisa's doctor, not her lover. He stood up quickly. "I'll get the paracetamol and compresses."


	8. Chapter 8

Joan arrived at the house early the next morning, bearing several dishes covered with foil. Martin led her into the kitchen.

"Thanks for coming so quickly." He'd called her at sunrise, explained the situation, and asked if she could stay with Louisa and the baby while he ran a few errands in town, including a stop to pick up the antibiotics for the mastitis.

"It's no problem, Martin. I'm glad you called me." She placed the dishes on the counter. "How is Louisa?"

"She's all right, though it was a long night," he replied. "Neither of us got much rest. She fed Tommy about an hour ago, so they're both sleeping now."

"Good."

"It's important that she rest. She needs to stay in bed other than using the lavatory. If the baby fusses, let him sleep with her—"

"I understand, Martin. I can handle it." She made shooing motions. "Go on and do what you need to do; I'll take care of Louisa."

Martin left the house a short time later with plans to stop first at the pharmacy. He'd covered only two blocks when he was stopped in the middle of the street by a woman walking briskly toward him from the opposite direction.

"Doctor Ellingham." It was Mrs. Richards, the mother of troublesome little Bobby. "I heard you were back."

Her voice held no warmth and Martin couldn't decide whether she considered his return a good thing, not that he particularly cared. For now, he simply wanted to be rid of her and on his way. "Yes."

"Didn't like London?" she said in what was almost a sneer.

"Is there a point to this conversation?"

"I took Bobby to the new GP on Tuesday," she announced in a tone that suggested she was quite pleased with herself. "_He_ serves tea and Poppy makes a mean cup of tea."

"I'm sure she does."

"Doc Owens said Bobby has strep. Prescribed _antibiotics_," she announced triumphantly. Martin had no doubt she intended to remind him of the last time he'd seen Bobby for a viral upper respiratory infection and refused to prescribe antibiotics, much to her consternation.

"Antibiotics are an appropriate treatment for a streptococcus infection."

"I just thought you should know."

"Consider me informed," he replied and pointedly stepped around her.

It was only a short distance to the pharmacy and, a few minutes later, he was pushing open the front door.

"Well, if it ain't the Doc!" Bert Large's large body seemed to fill the small shop.

"Bert." He acknowledged the man with a slight nod. He didn't see Mrs. Tishell and he assumed she must be in the back room.

"How's Louisa?" Bert asked. "I've been meaning to come over to see her and the baby but I figured she'd probably be a bit tired at first—"

"She is. Tired."

"And the baby? Tommy, I hear he's called."

"He's fine."

"Heard you're staying there. With Louisa, that is."

"Yes."

"Went to see the new Doc yesterday. You won't believe all that's happened."

It seemed that the entire village had already visited the new GP. Clearly they had nothing better to do and, apparently, neither did the illustrious Dr. Owens. "Let me guess. He's rearranged the furniture, Pauline is gone, and Poppy makes excellent tea."

Bert looked crushed. "You've heard."

"And I don't care."

"Went to see him about my knee pain." Bert pointed toward his left knee. "Said it was bursitis."

"Good." He rolled his eyes with relief at the sight of Mrs. Tishell returning to the front room, wearing the familiar neck brace. "Mrs. Tishell," he said formally.

"Doctor Ellingham! I heard you were back. I've been waiting for you to stop by."

"I need Augmentin, a 14-day course of 875 milligrams."

"It's so good to see you again, Doctor and _so_ good to have you back." She gave him a look that only be described as lecherous. "I've missed you. Doctor Owens has been here a few times. He's nice enough but," she batted her eyes suggestively, "he isn't you."

He tapped on the counter in annoyance. "The Augmentin, please."

She frowned. "Do you have sinusitis?'

"No."

"Then the Augmentin is for . . .?"

"A patient."

She clearly was disappointed in his answer. "Doctor, you know that, as the pharmacist, it's important for me to know who is taking what medicine to ensure there are no interactions, no contraindications—"

"Mrs. Tishell," he said tightly, "will you please. Get me. The Augmentin."

"Of course, Doctor. Right away." She sighed pointedly and turned away to fill the prescription.

While he waited, he picked up a few items from the list Louisa had given him as well as some additional toiletries for himself. Until he had a permanent place to live, it didn't make sense to have any of his possessions redelivered so, for now, he needed to replenish his supplies.

"Have you had a chance to wear the sweater?" Mrs. Tishell asked over her shoulder.

He paused in the midst of selecting a Vaseline ointment, thankful that Bert had left the shop. "What sweater?"

"The one I made for you, of course."

Oh, that awful thing emblazoned with his name that had long since gone to the landfill – or the incinerator. "Uh, no. Not yet."

"Yellow really is your color, you know. It goes well with your gorgeous blue eyes."

He was saved from a response by the entry of a young man. It was Dale Nevis, the owner of the local electronics store. Dale was – had been – one of his less annoying patients and someone with whom he rather enjoyed discussing the latest in electronic gadgets.

"Doc," Dale said, as he moved toward the counter. "Good to have you back in town." The man gave him a quick wink. "I hear you might be needing the 'family plan' for your mobile."

"I'm, uh—"

Dale smiled. "It's a joke, Doc. But if you do decide to upgrade, you know where to come."

"Yes, I do." And, if he and Louisa were to remain together, it might make sense to consider a change in their mobile plans.

"I was in to see Doc Owens this morning," Dale said. "Still got the runs."

Martin frowned. "Still?" He'd treated Dale for persistent diarrhea at least several times in the past few months.

"Yeah, can't seem to shake it."

Martin scanned the young man's lanky frame and his frown intensified. "Have you lost weight recently?"

Dale nodded. "About ten pounds in the last month or so even though I've been eating like a horse."

Mrs. Tishell turned back to face them, a bottle of Augmentin in hand. Martin deposited his other items on the counter and, after handing over his card, waited as she rang them up.

"Did you inform Dr. Owens about the weight loss?" he asked. The recurrence of the diarrhea would be obvious from Martin's copious patient notes but, given that Owens was new, he might not notice that Dale was clearly thinner than a few months ago.

Dale shrugged. "Didn't think about it."

"What did Dr. Owens prescribe?"

Dale unfolded the sheet of paper he was carrying. "He told me to get some . . . loperamide."

It was an anti-diarrheal medication that should be effective but clearly wasn't, given that Martin had already prescribed it for Dale in the past and yet his condition was still recurring.

"Dale, last time when you came to see me, I mentioned that, if your condition didn't improve, it would be prudent to make further tests."

"Yeah, I remember. And you probably remember that I'm not too keen on someone shoving a scope up my arse." Dale turned to Mrs. Tishell, slightly red-faced. "My apologies, ma'am."

"Dale, persistent diarrhea, especially when coupled with unintended weight loss, can be an indication of a more serious condition. I recommend that you tell Dr. Owens about your other symptoms so he can make a thorough evaluation. In particular, you might mention to him the possibility of Crohn's disease."

"What?" Dale gave him a quizzical look.

"Crohn's. C-r-o-h-n-apostrophe-s. The symptoms you describe are consistent with that disease."

"Uh, sure. I'll do that," Dale replied in a tone that suggested to Martin he intended no such thing. Damn.

"Here you go, Doctor," Mrs. Tishell interrupted, handing him his supplies in a bag.

"Thank you," he said tightly.

Martin found himself balling his fists as he walked out of the pharmacy. He'd been seeing Dale Nevis as a patient for over three years; Owens for a single visit. Martin was certain that Dale's symptoms indicated a more serious problem. Yet, he was no longer Dale's doctor and Dale was unlikely to mention his symptoms to his current doctor. And Martin would only antagonize Owens further if he tried to intervene.

In the meantime, Dale was likely walking around with a condition that needed specialized treatment. What a bloody mess!


	9. Chapter 9

The first thing Martin realized about his stint as a consultant in Truro was that he lacked the control he had over his own surgery. His consulting room in the hospital was not actually his own and, instead, was shared with two other consultants who worked the alternate days of the week. Thus, he had virtually no ability to reorganize or rearrange anything. Still, the room was both adequate for its purpose and held the necessary supplies.

The second thing he quickly noticed was that the complaints he handled as a consultant in Truro were not unlike those he'd dealt with the past several years as a GP in Portwenn. In his first two days here, he'd seen two URIs, as well as one each of UTI, hypertension, angina, diabetes, sinusitis, a testicular lump, back pain, migraine, and tonsillitis. There was an unusual case of Meniere's disease and a likely case of Addison's that he'd sent for additional testing.

Parsons had stopped by at lunch on his second day on the job. "So, are you finding the cases here more challenging than those you saw in Portwenn?"

"Not particularly, no."

Parsons smiled weakly. "Sorry, but there's not much I can do about that."

"It's fine." And, in a way, it was. At least, he was working. It might not be Chief of Vascular Surgery at Imperial but it was better than sitting in Louisa's house all day or, worse, walking the streets of Portwenn and being besieged by locals demanding to know why he wasn't in London.

"Are you driving back and forth each night?"

"No. I've taken a room at a local hotel."

"Makes sense. Well, I'll leave you to it. If anything comes up, don't hesitate to call me."

He didn't have cause to call Parsons, but he did call Louisa during an afternoon break between patients. She'd been on the antibiotics for several days now and her symptoms had improved significantly before he'd left. Still, he'd been hesitant about leaving her alone, and only Joan's promise to check in on her and the baby every day had given him sufficient reassurance to make the trip to Truro.

"Louisa, how are you feeling?" he asked when she answered his call.

"I'm fine, Martin. Joan's been here most of the day. She's a godsend."

"Any fever?" he asked.

"No."

"How's the pain?'

"Much better.

"And Tommy?"

"Good. He slept from two until nearly six-thirty. It's the longest he's gone yet. What about Truro? How is it?"

"Predictable. I'll come ho- . . . back tomorrow night after rounds."

"Good. We need to start planning for the start of school. It's less than two weeks away. We still need to find someone to watch Tommy during the day. I've talked with Joan and, with the farm and the B&B, she could only do it once or twice a week at most."

Martin bit down on his lip. He understood that Louisa wanted, even needed, to go back to work. But he didn't see how she could manage all of the duties of being head teacher while also caring for a newborn, even with help.

"Have you reconsidered working less than a full schedule?"

"No, Martin, I haven't reconsidered. I'm not the first woman to have a child and be head teacher at a school. If other mothers can make it work, so can I."

This was still a sore point between them. Every time he voiced his concerns, Louisa became incredibly defensive, pointing out that he considered it fine for him to work a full schedule but not for her to do the same thing.

"I just think it would be easier if you didn't try to manage two full-time jobs at the same time," he said.

"I'm sure it would." As always when she got angry, Louisa's Cornish accent became even more pronounced. "But I applied for the position and I got it. How would it look if I backed out of it now, just days before school is set to start?"

"It would look," he said, voice rising, "like you'd finally come to your senses."

"Why is it that 'coming to my senses' always means agreeing with you? Why must your view of the world always be right?"

"I'm not . . . I'm simply trying to make you understand that . . ." God, it was hard having this conversation by phone.

"I don't need you to make me understand anything, Martin. It's you who needs to understand that this is the 21st century."

In the background, Martin heard the sound of Tommy starting to shriek.

"The baby needs changing. I've got to go."

"Louisa—" he started, but she'd already hung up the phone.

He leaned back in his chair, tilted back his head, and stared at the tiled ceiling panels. Dealing with Louisa could be so frustrating at times. He wasn't trying to stop her from working, but the woman had only one speed and that was full throttle. Had she forgotten about her bout with anemia last year when she'd overworked herself? And now she was planning to add full-time mothering to the more than full-time job of being a head teacher. It was insanity.

And the only thing more insane was that Louisa didn't seem to realize what she was in for.

He took a long cleansing breath, before calling for the next patient.

The woman who entered the consulting room was a twenty-year-old university student who took one look at him and rolled her eyes skyward. "Another new consultant! Every time I come here they give me someone new."

Martin glanced down at her notes. "I'm afraid it's going to be bit difficult for you to see Dr. Symington again."

"Why's that?"

"He's dead."

"Oh."

"So, do you have a medical complaint?"

"Yeah, I've been getting this tingling in my fingers and toes when I get cold."

Wonderful. He flipped through her patient notes, finding nothing remarkable. "When did you first notice this?" he asked, doing his best not to sound bored.

She shrugged. "Maybe six months ago. I didn't think much of it at first, but it keeps happening."

"Do your fingers or toes ever change color or feel numb or painful?"

"Exactly!" She seemed surprised that he'd figured that out. "It was really bad when I did a semester in Oslo in the spring. It wasn't that cold but I was afraid I had frostbite."

"Does this only happen in the cold or do you find yourself having these attacks when you're under stress?"

She considered the question for a moment. "Now that you mention it, it happened during exams this year. And we were having a stretch of good weather for a change."

He stood up from the desk. "I think you may have a condition called Raynaud's disease. I'd like to put your hands in cold water to see if that brings on your symptoms."

She looked at him strangely. "Okay," she said, drawing out the word. "What is this Raynaud's you're talking about?" she asked as he filled a bowl with cool water, checking the temperature on his own hands. "Is it serious?"

"The attacks occur when small arteries that supply blood to your skin narrow, limiting blood circulation to certain areas of the body, typically your extremities. It's usually caused by exposure to cold or stress. And, no, it's generally not serious although the symptoms can be troublesome at times."

He placed the bowl on the desk in front of her. "Put your hands into the water."

She dipped her fingers into the bowl.

"Your entire hands – both of them," he ordered, watching carefully for her reaction. It took only seconds before the patient reported that her fingers were tingling. When she pulled her hands from the water less than a minute later, the fingers on both were white and numb to the touch.

"So I have this Raynaud's thing, huh?" she said, as she warmed her hands in a towel.

"Yes."

"How do I get rid of it?"

"You don't. There are things you can do to limit the number and severity of the attacks, such as avoiding smoking, caffeine, keeping your hands and feet warm in cold weather, and taking regular exercise to promote circulation. I'll give you a list. Come back and see me in a month – sooner if your attacks become more frequent or more severe. There are medications we can try but they have side effects and I'd prefer not to prescribe them unless absolutely necessary."

"Thanks, Doc."

No sooner had he ushered the young woman out of his office than his phone rang. On the line was the woman who functioned as the secretary for the internal medicine department.

"Dr. Ellingham, they need you in emergency for a consult right away. Bed four. The receptionist will let your patients know you're running late."

"I'll be right down." Martin cursed the gods that would now make him late getting home tonight.


	10. Chapter 10

The minute Martin entered the emergency department, it was clear they were in crisis mode. There was a bustle of activity around one of the beds – bed 2, which was not the bed to which he'd been called. He recognized the barely controlled chaos to which he'd become accustomed during his years as a surgeon.

As Martin moved closer, he could make out enough of the discussion to realize that the patient was the victim of a serious motor vehicle accident. He found himself inextricably drawn toward the closed curtains surrounding the bed, where house officers and nurses were calling out information about the patient's condition.

"BP's 100/50 and dropping."

"He's lost a lot of blood."

"Pupils reactive but unequal."

"Hang another liter of plasma and get a neuro consult. Has he been typed and cross-matched?"

"He's B-positive. Blood's on its way – two units to start."

"What've you got for injuries other than the arm?"

"Penetrating trauma to the abdomen but doesn't look like it hit any major organs. General surgeon's been paged. Severe lacerations to the face, chest, arms, and legs; none is life threatening. Probable fractures of the mandible, right clavicle, left femur and possibly the pelvis. X-ray's lined up and ortho will be down as soon as X-ray's done."

"Where's the goddamn vascular surgeon for that arm?"

"Dunno. We called ten minutes ago. Said they'd send someone straight away."

"Did you make clear the urgency?"

"Yes."

"Well call again! I'll be damned if he loses that arm because someone is too busy to see to him."

They were calling for a vascular surgeon, which probably meant that the arm either had no peripheral pulses or had been partially severed, or both. He was a vascular surgeon meaning he could help, should help. Hell, if he were in London right now, this is exactly what he'd be doing.

Martin took a step closer, his nose wrinkling at the smell of blood that permeated the small space. He swallowed hard and tried to focus on all of the work he'd done for the past weeks to conquer his hemophobia. Now was the time to prove to himself and everyone else that he'd actually done it.

It wasn't hard. He need only walk into the curtained area, announce himself, and see to the patient. Control, he reminded himself. He was in control. This was a routine procedure, one that he'd handled successfully many times. He would examine the patient, determine if the arm could be saved, send the patient to the operating theatre, operate to reconnect the severed arteries and veins, and make the man whole again. Simple enough.

This was why he'd become a surgeon. In his skilled hands lay the ability to save a patient's life or, in this case, his arm. He could restore what an accident had taken away. It wasn't all that technically difficult – for him at least. A little focus, some careful suturing, and the man would be good as new. He, Mister Martin Ellingham, FRCS and vascular specialist, could do this.

He took several deep breaths in succession and steeled himself for the task at hand.

The curtain flashed open as one of the house officers rushed out, his white tunic stained with blood. The curtain stayed open and, inside, all Martin could see was . . . blood. There was blood everywhere – on the shirts and trousers of the medical personnel, on the floor, on the patient. Before him was a sea of crimson.

Martin blinked, trying to take it all in, all the while trying to ignore the color and the sight and the smell. The smell. It was an overpowering odor that seemed worse now that it was coupled with the sight of all of that red. He breathed only through his mouth, focused his eyes on the few things not covered with blood – the IV bags, the ECG machine, the top of the nurse's head – and forced himself to take another step forward.

He could see the patient's lower arm, partially wrapped in gauze and almost severed at the elbow. Someone had inserted clips on the key arteries that remained intact. It was a mess.

"Mr. Ellingham," one of the house staff greeted him. "Are you the vascular consult?"

Oh, how he wanted to be. Part of his brain cried out for him to step up and take charge of the situation. He instinctively knew what to do – the examination to make, the tests to request, the medications to order, the procedures to line up. The actions and words rolled through his mind like his car rolling through the streets of Portwenn.

And yet, he couldn't move. Like the fingers of his last patient, he was numb. He felt the familiar symptoms and, hard as he tried, he was powerless to stem their effect. His heart started to race and bile forced its way to his throat. He needed to vomit. Now.

He was aware that the medical personnel inside the curtain were staring at him. He wasn't just a trained vascular surgeon, he was – or had been – a relatively famous one. They all knew his capabilities and undoubtedly wondered how he could stand here with a patient in critical condition and do nothing.

"Uh, no. I was called for a medical consult for the patient in bed 4," he managed to say.

Someone pointed to his left. "Two curtains down."

Right. The patient bleeding out in front of him needed a vascular surgeon right now. As he stood transfixed between rushing forward and streaking toward the lavatory, he heard a bustle from behind.

"Someone call for a vascular consult? I'm Dr. Ashton. What have we got?"

A woman in scrubs, slightly younger than he, pushed past, oblivious to who he was or the internal conflict raging within him.

"About time, Doc. MVA. Partially severed right arm."

"Let me see," she said, moving quickly to view the affected limb.

The curtain closed. The blood was gone. The smell was less intense. And, even so, Martin felt the incredible urge to vomit.

After seeing to his consult, an elderly man who turned out to have nothing more than a strangulated hernia, he again passed by bed 2, now empty of its patient and freshly cleaned by the janitorial staff. There was no indication of the battle that had been waged in the tiny cubicle only a short time ago.

Martin retreated to the doctor's lounge for a cup of tea before returning to his afternoon patients. He felt like a coward for being unable to attend the patient in the ER. Although his reticence hadn't changed the outcome of the case, the episode had been deeply troubling. Even in the midst of an acute emergency, he'd been unable to overcome his phobia. For all of his efforts over the past two months, it was almost as if he'd regressed since the episode with Peter Cronk years ago. The thought was disquieting.

He glanced up from sipping his tea as two male doctors entered the lounge in mid-conversation. House officers, Martin noted automatically. Young, inexperienced and cocky.

"That was pretty damn amazing," the first one said, heading for the cups and saucers.

"The arm was eighty percent severed," the second one commented. "I would have bet my flat that he was going to lose it."

The two men helped themselves to full cups of tea, adding sugar and milk, before taking seats across the room from Martin.

"Ashton said he should have pretty close to full use of it," the first doctor said.

"Did you observe the surgery?" his colleague asked. "She was fucking phenomenal."

"I only caught the tail end of it – stuck doing an LP."

"Well, at least you got to do a real procedure. Besides, they videotaped the surgery."

"Good. That's definitely what I want to do – be able to save someone with these very hands." He held them up in front of his face and turned them back and forth. "I'm definitely shooting for surgery. What about you?"

"I want to but the wife wants me to be a GP."

"Whatever for?" The tone was clearly disparaging.

The second doctor shrugged. "Quality of life, I suppose. You know surgeons have years of training and even then spend most of their lives in hospital. Rough on the family."

"Yeah, but you're actually saving lives. What the hell are you going to do as a GP? See kids with runny noses and give influenza vaccinations all day?"

"Yeah, that would suck."

"Look at what happened today. Ashton saved this guy's arm and maybe his life while your local GP was probably doling out BCPs or checking out a hernia or something equally useless."

Both doctors stood up.

"True, but being a GP's important too . . ."

The rest of the conversation was lost as the doctors stepped out of the lounge and Martin was left with his cold tea and his demons.


	11. Chapter 11

"Martin, that's the third woman we've interviewed," Louisa complained as she closed the front door, giving it a small slam. "Must you find fault with every one?"

Miss Eleanor Gaithers had just walked out in a huff. She was in fact the third person he and Louisa had interviewed to care for Tommy when Louisa returned to school. That date was now less than a week away and they'd yet to fill the nanny position – a situation for which Louisa clearly blamed him.

"I think you're looking for a reason not to hire anyone," she accused, "so that I won't be able to go back to school!"

"Can I help it if she starts every sentence with 'Well, you see' and can't hold her hands steady?"

"She's probably a bit nervous, which is understandable."

"This is the person we're going to entrust with our son! I don't think it's too much to ask that she speak in complete sentences and isn't a threat to drop his bottle or him onto the floor."

"You intimidate people, Martin."

He bristled at the comment. "If she's overwhelmed by a few simple questions, what will she do in a real emergency?"

"You always have to be right, don't you?"

"It's not a question of being right – it's about finding the right person to care for our child."

"Oh, so now it's 'our' child."

"Of course it's our child."

"There's another girl coming to interview tomorrow."

"A girl?"

"Well, she's twenty."

"I hardly think that's old enough—"

"Let's at least meet her and give her a chance. She has excellent references." Louisa yawned and lay back on the couch.

Martin worried about saying anything more for fear he'd trigger another argument. so he was content to sit quietly in silence.

"Are you working tomorrow?" Louisa asked him after a moment.

"No."

"Could you stay with Tommy while I run to school for a few hours? I need to meet with the new teacher and go over class lists and schedules with the others."

"Yes, I can."

"Why, thank you, Martin."

"You're welcome." He watched as she yawned yet again. "Perhaps you should go to bed. You want to be well rested for your meetings tomorrow."

"Yes, maybe I should." Her eyes met his. "Would you do something else?"

"Of course."

"Come to bed with me."

His forehead creased into a frown. "I don't understand—"

"I'm asking, Martin, if you would come with me to my bedroom and sleep in my bed. Is that such a hard question?"

"No," he replied hurriedly. "I would like that. But you know that we can't—it's too early—I mean, too soon after your delivery—to, well, you know—"

"Martin, all I'm asking is that we sleep in the same bed." She eased herself off of the couch and held out her hand for his. "We haven't done that in nine months and I think it's about time, don't you?"

He took her hand and smiled. "I do."

By the time Louisa returned from her meetings at school the following afternoon, Martin was at his wit's end. The baby was crying and had been crying for the past half-hour. He'd tried feeding, changing, holding, rocking, and now was back to feeding, all without success.

"Thank god you're back," he said, tilting the bottle slightly. Tommy defiantly kept his mouth away from the nipple of the bottle and continued shrieking, which caused milk to spill all over the baby's face and Martin's hands. White milk spots already covered his shirt and Tommy's and, to his consternation, he'd yet been able to change either.

"Ugh!" he said, shaking his wet hand in disgust.

"What's wrong?" Louisa asked, concern obvious on her features.

"How the bloody hell do I know?" he replied. "He won't stop crying."

"Martin, please don't swear in front of the baby," she said, reaching to take him. "Is he wet?" She started to check his nappie. Tommy seemed oblivious to the change of parents and continued to wail.

"He was dry ten minutes ago when I last changed him." Martin grabbed for a towel and tried to clean off his shirt.

"Maybe he just needs to be held."

"Don't you think I tried that?"

"Is he ill?" Louisa looked down at baby with a deepening frown and touched his forehead.

"Of course he's not ill. I am a doctor, Louisa."

"I know that, Martin," she said in a patronizingly patient voice. "What's the matter, Tommy? Why are you crying, sweetie?" She sat down on the couch, held him tightly to her chest, and slowly rocked back and forth. "It's all right, I love you little Tommy." She continued to rock and speak softly even as Tommy continued to scream. Thank goodness there was open space between Louisa's house and the neighbors or they probably would have been evicted by now.

Minutes went by and, just as Martin began to wonder if maybe Louisa was right and the baby actually had a medical problem, he noticed that the cries seemed to decrease in both volume and frequency.

"What did you do?" he asked as Tommy started to fall asleep.

She smiled. "Nothing that you didn't do. He's just worn himself out."

"So why was he crying?"

"Dunno. But he seems fine now. I've read that sometimes babies cry for no reason whatsoever."

Martin frowned. He touched his hand to the baby's forehead and then checked his pulse rate at the carotid. When he discovered both were perfectly normal, he relaxed and sat down next to Louisa.

"So how was school?" he asked.

"There's so much to do. I think the new teacher will be fine. He's fresh out of university but, after Mr. Strain, it's good for the children to have a male teacher who's . . . normal." She reached out and ran her fingers along Tommy's arm. "So other than the crying how was my little boy today?"

"I fed him twice and he went down for a nap before lunch." Martin was moderately pleased with himself. He'd managed to take care of Tommy without incident, at least until the final crying fit.

"Any problems with the feeding?"

"No."

"Martin, do you know Alice Givens, our art teacher? She started last year."

The name wasn't familiar. He shook his head. "I don't think so."

"Alice didn't come into school today. When I called, she said she had to stay home because her daughter was ill."

"That seems sensible." Sometimes he had difficulty following Louisa's train of thought.

"She said Beatrice – that's her daughter – has a fever and a really bad headache."

"How old is she?"

"Alice?"

"No, the child."

"She's eight, I think. Tommy twisted slightly in Louisa's arms then settled back to sleep.

"Well, fever is a common symptoms of childhood illness. Has she been otherwise healthy?"

"I guess so. She hasn't missed any school. I take it you've never seen her."

He shook his head. "No. Has she taken the girl to see Owens?"

"Yesterday. He thought it was the flu. Isn't it odd to have flu this time of year?"

"The influenza virus is more common in the late fall and winter but can present at other times of the year."

"Oh. Alice said her daughter seemed worse today."

"And her qualifications for making such a judgment are?"

"She's the girl's mother."

"Right." He grimaced in empathy as Tommy drooled spittle onto Louisa's sweater. "She probably has a virus, most likely influenza as Owens said. The illness simply needs to run its course."

"I promised her I'd stop by tonight with the lesson plans and class lists. Would you come with me. Maybe you could have a look at her?"

"Louisa, she's Owens' patient. If the woman's concerned about her daughter's health, she should phone him. It's not my place to interfere."

"I'm not asking you to _interfere_, Martin. I'm asking you to drive me to her house so I don't have to make the drive alone. While you're there, maybe you could take a quick look at the girl. If she's all right, you'll save Owens a trip. And, if she's worse, Alice can phone him."

Martin considered the request. From a professional standpoint, his staying in Portwenn was quickly becoming awkward at best. He'd left of on his own volition; Owens was now the GP and didn't need Martin looking over his shoulder at every opportunity. Martin knew how he'd feel if their positions were reversed.

Nonetheless, what Louisa was asking wasn't all that difficult. He could check on the girl and, if he had any concerns, have the mother follow up with Owens. Moreover, it would alleviate Louisa's worry and stem another argument.

"All right, I'll come with you."

"What do you think Martin?" Louisa asked when they were a few miles down the road toward the Givens household. "Should we hire Tanya?"

Louisa was referring to the young woman they had interviewed the day before to be Tommy's nanny. Although only twenty years of age, she came across as more mature. Louisa had spoken with her former employer who was glowing in her praises. The employment had ended only because the mother had moved to Dorset.

"It's your decision," he said.

"It's your child, too. Don't you even care?"

"Of course I care." It was hard to carry on this conversation while he was forced to keep his eyes on the road ahead.

"School starts next week. If we don't hire her, what are we going to do?

"I don't understand why you didn't think about this weeks ago."

"Oh, I don't know, Martin. Maybe I was trying to deal with giving birth prematurely in a tavern, finding a place to live, the baby's father moving to London, taking up with his old girlfriend—"

"I did not 'take up with' Edith." He briefly glanced over at Louisa but her expression was unreadable. "I was assisting her with a research paper and speech," he added lamely.

"Whatever."

He needed to get this conversation back on track. "If you consider her qualified, you should hire her."

"Edith?"

He hated when she was sarcastic. "The nanny."

"All right then. I'll phone her tomorrow."

She'd called his bluff. "Hmm."

They made the rest of the drive in silence and, fifteen minutes later, pulled up outside the Givens home, which comprised the left side of a two-story duplex on a spit of land.

"You go on ahead while I get Tommy," Louisa said.

"Um, all right." He opened the back door of the Lexus and retrieved his medical bag as Louisa started to unstrap the baby from his car seat.

After a hard knock, the door was opened by a thin, dark-haired woman who didn't appear to be much over thirty.

"Mrs. Givens? I'm Dr. Ellingham. Louisa said your daughter was ill."

"Oh, Doctor, thank you for coming. I've been so worried."

"If you're so worried, why didn't you call the GP?"

"Well, I was going to—"

"Never mind." At her invitation, he stepped into the front room. "What are her symptoms?

"As I told Louisa, she's had fever and such a headache."

"All consistent with influenza. Any other symptoms?"

"Well, I don't know if it's important—"

"Any symptom is important."

At the next words out of the mother's mouth, Martin turned on his heel and rushed outside, where Louisa was approaching the house carrying Tommy in his carrier.

He stepped in front of her. "Get back in the car!"

She stared at him in obvious surprise and confusion. "What?"

"Now!" he ordered, using his surgeon's voice. "Take Tommy and go back to the car. Whatever you do, don't come into the house."

"Why not?"

"I'm not certain, but it's possible that the child may have a very serious and communicable disease."


	12. Chapter 12

Back inside the house, Martin followed the mother up the steep stairs. "When did she first become ill?"

"Yesterday morning," the mother said from above over her shoulder. "She woke up with a high fever, so I took her to the GP right away. He said she probably had the flu. Said to keep her home, give her fluids and to call him if she got worse."

"Did you?"

"What?"

"Did you call Dr. Owens again?"

"Uh, no. Louisa said you were stopping by so I—"

He shook his head in frustration. "Right."

They entered the girl's room, which Martin noted in passing was decorated in a shocking and somewhat hideous shade of pink. Pink rug, pink sheets, even pink wallpaper. Of greater interest to him was that all of the window shades were drawn, leaving the room unnaturally dark.

"What's her name?" Martin asked, unable to remember what Louisa had told him only a few minutes ago.

"Beatrice."

During his tenure as a GP, Martin had discovered that he could often determine the severity of a child's illness simply from the body language when he walked into the room. For her part, Beatrice seemed lethargic and disinterested in the stranger who approached. Neither was a good sign.

"Beatrice, I'm Dr. Ellingham. How are you feeling?" He sat down next to her on the pink bed and reached for her pulse, feeling the heat radiate from her body.

Tired eyes gazed up at him. "I'm sick."

"I can see that."

The room was so dark that he was having trouble seeing the contents of his medical bag. "Can you open up the curtains?" he asked Mrs. Givens.

As the mother did as requested and a ray of early evening sunlight filled the room, Beatrice covered her eyes.

"Does the light bother you?" he asked, frowning.

"A little."

He retrieved a thermometer and his stethoscope from the bag and checked her temperature – 103.6. He twisted to face the mother. "Her fever's quite high. Have you given her anything for it?"

"Paracetamol this morning."

The effect of which would have worn off by now. "Hmm." He put the stethoscope in his ears, moved aside the girl's nightshirt, and pressed the bell to her chest.

"Breathe in and out," he ordered. "Slowly. In . . . and out." He noted that her heart rate was slightly elevated, but the heart and lungs otherwise sounded normal and clearly not indicative of influenza.

"Can you sit up?"

The girl slowly and carefully started to push herself up from the bed and almost immediately cried out.

"Beatrice!" her mother said, stepping closer. "What's wrong?"

The girl moaned slightly. "My neck hurts."

It was the symptom the mother had mentioned a few minutes ago – the one that had caused him to ban Louisa and the baby from the house. With a sense of foreboding, he helped the girl into a sitting position then reached one hand under her chin, placed the other on the top of her head and gently tipped the neck forward.

The response was immediate and severe. "Don't! Please!" The girl's neck was stiff and movement obviously painful. "It hurts."

He frowned again and turned back to the mother. "Where's the girl been the last two weeks? Around here?" God help them if the village was facing an epidemic.

"She's been away with her dad. We're divorced," she added.

"Where were they?" he demanded.

"They went on holiday in Africa."

That certainly made his diagnosis more likely. Martin pulled out his phone and dialed 9-9-9. "This is Dr. Ellingham from Portwenn – sorry, Truro Hospital. I need an ambulance at—" He turned to the mother. "What's the address here?" She gave it to him and he repeated it for the dispatcher. "Immediately, please. And have them bring IV cefotaxime for pediatric use."

"An ambulance?" The mother was wringing her hands. "Oh, my god. What's wrong?"

"Shush." He hung up, stepped out of the room and quickly redialed. "Owens, it's Ellingham. I'm at the Givens house. I've just examined the girl; it looks like she has meningitis – probably bacterial. I've called for an ambulance."

"You've—what? Meningitis? You're not serious."

In the background, Mrs. Givens was nervously hovering.

"Someone should accompany the child to hospital in the ambulance," he continued, ignoring her. "It should be here in about thirty minutes."

"I'm jumping in the car now; I'll be there in twenty. But I want to know why you think she has meningitis."

"High fever, severe headache, photophobia and stiff, painful neck," Martin summarized succinctly. "And, she was recently in Africa."

There was a slight gasp on the other end of the line. "Oh." A moment later, he added, "I'm sure she didn't have a stiff neck yesterday when I examined her."

"That's not important now, is it?"

After hanging up with Owens, Martin walked back to where the mother was standing. "I think your daughter has bacterial meningitis."

"Meningitis?"

"We won't know for certain until we get her to hospital and perform a lumbar puncture."

"Oh, my god. Is she going to-"

"It's all right. We're getting her to hospital right away. If it is meningitis, there are antibiotics that are very effective."

"So she'll be all right?"

"Yes, I expect so."

"Oh, thank god. She was so sick and I didn't know what to do. I don't know how to thank you, Doctor. If you hadn't come—"

"Bacterial meningitis is a very serious condition. It's critical that treatment be started early. It was foolish of you not to call Dr. Owens as he requested when her condition worsened."

"I didn't realize, I thought it was just the flu. If I've done anything to hurt her—"

He brushed aside her disclaimers. "Dr. Owens is on his way. I'll just go outside and speak to Louisa."

Once there, he briefly explained the situation.

"Meningitis sounds so serious," Louisa said when he'd finished.

"It is. Thankfully, it's been diagnosed in time."

"You mean _you_ diagnosed it in time, Martin. She _is_ going to be all right, isn't she?"

"Yes, I expect that she will." For Martin, the diagnosis hadn't been particularly challenging. It was a straightforward case. Nonetheless, he smiled inwardly at the compliment, especially coming from Louisa.

"Isn't meningitis contagious?" she asked. "Are you in any danger?"

And, she was asking, was Tommy in any danger. "Yes it's contagious and no, I'm not likely to become infected. The bacteria are only passed through the exchange of respiratory secretions, such as by coughing or sneezing. It's not enough simply to breathe the same air."

"Well, that's a relief."

He glanced back to the house. "Look, I need to get back. Are you all right to take the car home with Tommy?"

"Of course, Martin. But how will you get home?"

"I'll wait until Owens gets here and then call for a taxi." He took her hand. "I'll see you in an hour or so."

They both looked up at the sound of an approaching car. Dr. Owens had arrived.


	13. Chapter 13

Owens grabbed his backpack from the backseat of the Land Rover, slung it over his shoulder, and ran toward them. "How's Beatrice?" he asked then nodded at Louisa. "Evening."

"She's stable for now. I was just going to check on her," Martin replied. "There's not much we can do until the ambulance arrives."

"So what exactly _are_ you doing here?" Owens asked. "She is my patient."

Louisa stepped forward. "I came by to drop off some school materials for Alice," she interjected. "I knew it would be late getting home so I asked Martin to drive me over. When we arrived, Alice was very concerned about Beatrice, so Martin-"

Martin waved off her explanation. "I think the girl's condition is more important than how I ended up examining her."

"I told Alice to call me if the girl's conditioned worsened," Owens said. "If she had, I'd have come out here right away."

"I don't doubt it," Martin replied. "And it was stupid of her not to call you. Now, should we see to the patient?" He turned toward the front door.

Owens touched his arm. "Look, I appreciate what you've done, but there's no need for you to stay. I can handle the rest myself."

Martin shrugged off the physical contact. "And what do you plan to do for the girl?"

"Like I said, she's my patient." Owens crossed his arms over his chest, one shoulder slightly lower with the weight of the backpack. "What business is it of yours?"

"I diagnosed her and as such I have a vested interest in ensuring her recovery." Out of the corner of his eye, Martin could see that Louisa's eyes were bright and she seemed to want to interrupt their conversation – probably to tell him that he was being obnoxious.

"Are you saying you don't trust me?" Owens challenged.

"It's not a matter of trust. It's a matter of knowing what to do. Have you ever seen an actual case of bacterial meningitis?"

Owens refused to back down. "No, but that's not unusual; lots of doctors haven't. I've certainly read about it."

"Hmm. So what do you plan to do for her?" he repeated in the tone of voice he'd so often used when quizzing his surgical registrars.

"Get her to hospital. Perform an LP of course." Owens shook his head. "Why am I answering to you?"

"What about starting her on antibiotics?"

"Antibiotics?" Owens asked in obvious surprise. "Already? You're that certain she has bacterial and not viral meningitis?"

"Yes," Martin replied. "I've asked the ambulance to bring IV cefotaxime."

"What if you're wrong? You'll have given her antibiotics for nothing and she'll have to complete the full course."

Certain of his diagnosis, Martin refused to back down. "And if I'm right and we don't get her started on treatment right away, she could die. I'm not willing to risk that, are you?"

"You're pretty damn sure of yourself."

"Yes."

"Well, you may believe in prescribing antibiotics on a hunch, but I don't. It's not smart. There's a reason we're dealing with antibiotic resistance."

"It's not about being smart, Owens, it's about being right. We can't not treat this girl simply because you and I disagree. If I'm wrong, you can have at me later. But if I'm right, and we don't treat her now, she might well die. Then how will we feel?"

What Martin didn't add, what he wanted to say, was that, as the GP you had to take risks. You were on your own, you had to assume a worst case scenario and treat for that. Sometimes you were wrong, as Martin had experienced firsthand on more than a few occasions. But sometimes the risk in being cautious was greater and, in this case at least, one he wasn't willing to take.

Louisa stepped closer until she was almost between them. "I'll leave you both to it. Tommy's going to need feeding in a few minutes and I want to get home before that happens."

"Yes, go ahead," Martin said, not taking his eyes from Owens. "I'll be there as soon as I can."

As she made her way to the car, they heard the sound of the approaching ambulance.

"I'll go in and get her ready," Owens volunteered.

"I want to get the cefotaxime started before she leaves," Martin said.

Owens shrugged. "Okay, if you want to act precipitously, I suppose I can't do much to stop you."

Later that night, Martin sat alone in Louisa's living room, sipping a glass of water. Louisa had gone to bed an hour ago. He knew she wanted him to come with her but he was awaiting Owens' call about the girl. The GP had accompanied her in the ambulance with a promise – which was really more of a threat – to phone him with an update on her condition.

Maybe he'd been too hasty with the cefotaxime. Her condition could well be viral, not bacterial, thus not requiring antibiotics. Given the available facts and his physical examination, the diagnosis was reasonable, but only a lumbar puncture and examination of the cerebrospinal fluid could provide confirmation. He could well be wrong, as he'd been with the water issue and so many others over the years and, if so, once again, he'd bear the brunt of Portwenn's cruel mockery.

His mobile rang and he hastily pressed the answer button lest the noise wake Louisa or the baby. "Ellingham."

"It's Owens. They did an LP on the Givens girl."

Martin held his breath. "And?"

There was a brief pause before Owens answered. "You were right," he said, resignation obvious in his voice. "It was Bacterial meningitis. _S. pneumoniae_. The pediatrician consultant said that starting her on cefotaxime when you did was the absolute right thing to do."

Martin exhaled with relief. "Prognosis?"

"Excellent." A pause. "Thanks to you."

Martin took no pleasure the despair and anguish that was evident in Owens' voice. The stupid mother hadn't called him when she should have; thus, he hadn't been afforded the opportunity to diagnose the child properly.

"You would have made the same diagnosis and decision had you been there," he said.

"But I wasn't," Owens replied bitterly. "And I didn't. I didn't even want to give her the antibiotics."

Martin wasn't sure what to say.

"The girl could have died," Owens said. "I could have been responsible for her death."

"Stop it, Owens. You said yourself that she's not going to die."

For a long minute there was silence on the line.

"Owens?"

"Yeah."

There were so many things Martin wanted to say. He wanted to tell Owens that you didn't always get it right. That being there was equally important. That it didn't matter how you eventually figured out the diagnosis and that is was perfectly fine to ask for help. That, sometimes, even when you did do everything right, the outcome wasn't good. That you always were blamed for your failures and rarely praised for your success. He wanted to say it all.

But he knew that the new GP wouldn't listen to him, at least right now. And there were some things one needed to figure out for himself, and this was one of them.

"It's been a long night. Get some rest," he said, and hung up the phone.


	14. Chapter 14

Two mornings later, Martin hurried through the streets of Portwenn, Louisa's penciled list in hand. Given the option of caring for the baby or running errands, he'd decided to make the rounds of the village businesses. He was managing with Tommy but still felt inept and uncomfortable doing the routine daily tasks required in caring for an infant.

He stood outside the produce shop, dropping tomatoes, lettuce, sweet potatoes and radishes into his bag when Mrs. Travis, former patient and produce store owner, ventured outside.

"Well if it isn't Doc Martin," she said. "How're Louisa and the baby?"

"Both fine." He carefully selected several red apples and added them to the contents of his bag.

"Is Louisa all set to start school on Monday?"

"Yes, she is."

Bert Large approached them from across the street. "Hi, ya, Doc."

Martin nodded in greeting. "Bert."

"So, Doc, I hear you're quite the hero."

Martin stared at him blankly.

"You know – saving little Beatrice's life."

"I didn't save her life," he snapped. "Antibiotics did."

"I wouldn't know about that. But you figured out it was meningitis after Doc Owens got it wrong."

"First of all, Dr. Owens did not 'get it wrong' as you put it." For some odd reason, Martin felt compelled to defend his successor. "His diagnosis was reasonable at the time."

"That's not what the docs at Truro told Alice. They said if you hadn't figured it out when you did, Beatrice might have died. Now, is that true or not?"

"Prompt treatment of bacterial meningitis is important."

"I'd say the right diagnosis was also important," Mrs. Travis added. "Good on you, Doc."

"Yeah, it was a good thing you were here and not in London," Bert said. "Who knows what would have happened, right?"

"Right." Martin shrugged off the compliment and paid for his groceries. Bag in hand, he headed for his next stop at the electronics store. As he pushed open the door, a bell jingled and a few seconds later, the owner promptly met him at the counter.

"Finally decided to change your phone plan, eh Doc?" Dale Nevis greeted him with a knowing smile.

"Yes, I have."

"I take it you want yourself and Louisa on the _family_ plan." Nevis winked at him.

"Yes."

"Easy enough to do. Let me just get the proper forms."

Now that the store was silent, Martin heard the familiar voice of Caroline on the radio, coming from the rear of the store.

"As everyone knows," she was saying, "Monday is the opening day of school and Thursday is back to school night for parents."

Martin sighed. This would be an extremely hectic week for Louisa – and for him. It would also be the first test of whether she could handle her job at the school and simultaneously care for Tommy.

"Speaking of children," Caroline continued, "as many of you know, our old GP, Doc Martin, is back in town. And two nights ago, he saved the life of one of our very own children, Beatrice Givens—"

Nevis walked back to the counter. "Hear that, Doc? You're the talk of the town."

"Aren't I always?"

"But this time they're actually saying good things about you."

"Yeah." The last thing he wanted was to be the topic of radio conversation. He'd hated it when he was the GP here and hated it even more now that he wasn't. He'd simply done his job as a doctor, nothing more. There was no call to make a fuss about it.

Nevis put a form in front of him. "Just fill this out. Looks like you'll save about twelve pounds a month."

Martin pulled a pen from his breast pocket and started filling in the blanks. It was almost more complicated than registering with his practice.

"So how do you like working in Truro? Bet you're seeing lots more interesting cases then you did here."

"It's not that different," he replied honestly. "I see patients with medical complaints."

"But they must be really complicated, right? I mean to see a consultant and all."

Not really, Martin said to himself. Of course he'd been called upon to see a handful of complex cases that the local GP had been unable to diagnose. But, for the most part, the patients presented with the same sort of garden-variety illnesses and diseases that he'd come across in his years in Portwenn.

The biggest difference – maybe the only difference other than the commute – was that, in Portwenn he'd known most of his patients. They were the pharmacist, the schoolteacher, the banker, the attorney, the fishermen, the electronics store owner. As a consultant in Truro, as in London, his patients were just that – patients – people whom he saw first and last when they walked into and out of his consulting room.

"There are some challenges, yes," Martin finally replied.

"By the way," Nevis continued. "I did as you suggested and went back to Doc Owens about my diarrhea. He sent me for some tests. Turns out you were right – it was Crohn's."

Martin glanced up from the form. "Good. I mean, it's good that they sorted out what caused your symptoms."

"And speaking of medical issues," Caroline's voice came over the radio. "Our next guest is our dentist, Dr. William Richards, to talk about something new he's offering called 'sedation dentistry.' So, Dr. Richards, does this mean I'll be asleep while you're working on my teeth?"

"Well, Caroline," came Richards' deep bass voice. "Not always. There are varying levels of sedation. It depends on your level of anxiety and the amount of dental work you need done . . ."

"Pretty neat, huh?" Nevis said, reviewing the completed form. "You can be asleep while they drill on you."

Martin shook his head. He made regular visits to the dentist – they weren't pleasant but they also weren't that painful. He didn't understand why anyone would need to be asleep – or take the risk of being sedated by a dentist, for goodness sake – simply to have a cavity filled.

"All right, Doc. Here you go." Nevis handed him a copy of the form. "New plan will start tomorrow and is good for a year. Anything else I can help you with?"

"No, thank you," Martin replied.

He paused to hear more of Dr. Richards' continuing explanation. "There's nitrous oxide – laughing gas – that works for most people."

Even though it wasn't an analgesic, Martin said to himself.

"And, for severe cases, there's even general anesthesia. You can be completely out for the entire procedure."

Martin shook his head once more, retrieved his bag of produce, pulled open the front door of the store, and stepped out into the rare Portwenn sunshine. His foot immediately hit something and he tripped, nearly tumbling to the ground. Only a quick hand to the pavement saved him from a serious fall.

The bag of groceries wasn't as lucky. It broke open, spewing fruits and vegetables across the street.

It was that bloody little dog, he realized as he pulled himself to his feet – the one that seemed to follow him everywhere. "You could have killed me!" he shouted.

Oblivious, the dog sat on its haunches and cocked his head.

Nevis, who'd come out of the store at the sound of the commotion, gave him a fresh bag and helped him recapture the runaway produce. Unfortunately, the dog felt no compunction to leave.

"Go home! Shoo! Get away!" It seemed the harder he tried to push away the dog with his feet, the more determined the beast was to stay close.

The next stop was the fish market down at the harbor. On the way, several villagers hailed him and the bloody dog took every opportunity to rub against his leg or nibble on his trouser. He continued down the hill ignoring the villagers and the dog. Once he'd reached the market, Martin selected two perch and waited for the fisherman to wrap them up.

"Heard you saved Beatrice Givens the other night," the fisherman said, grabbing a large piece of newsprint and slapping the fish into it.

After the radio piece, everyone in the village probably knew what had happened. Blasted Caroline. He was beginning to wish he'd stayed home to care for the baby. "I looked after her, yes."

"Alice said you came out to the house at night even though you're not our doc anymore."

"I drove Louisa to visit Mrs. Givens."

"And you took care of the girl. They say you figured out what was wrong right away."

After years of frequent negativity, it was odd having the village folk talking about him in a positive way. Yet, it was still gossip and still made him uncomfortable.

"I was doing my job as a doctor," Martin replied, pulling out his wallet.

"It's supposed to be Doc Owens' job, now, isn't it?"

"He arrived shortly after I did." Martin knew what it was like to be on the side of village criticism and, despite any reservations he might have about Owens, had no interest in joining the current round of condemnation.

The fisherman brushed aside his effort to pay. "This one's on me, Doc. Alice and little Beatrice are right special. I can't thank you enough for what you did."

"Ah . . . you're welcome." He took the wrapped fish from the man and added it to his bag of groceries. As he turned around to start the trek back up the hill, he nearly ran into Geoffrey Owens.

"Martin, good morning."

He nodded curtly. "Morning."

"I saw Beatrice last night at hospital," Owens said. "She's doing well."

"That's good." Martin didn't add that he'd also checked on the girl before he'd left Truro the night before.

"You're the talk of the town," Owens said and Martin tried to decide whether Owens was jealous, mocking him, or merely stating the obvious.

"Unfortunately."

"I am too – and not in a good way."

"That can happen in a small town like this. They'll get over it."

"I hope so. I want to be a good doctor for this village." Owens squinted up at him into the sunlight. "I must admit, though, that you're a tough act to follow."

"I'm not trying to make things difficult—" he started. The situation was awkward enough without the locals stirring the pot.

"I know," Owens said abruptly. "But they are difficult, aren't they?" he asked, then without another word stepped aside to allow Martin to pass.


	15. Chapter 15

"To use an overused expression," Aunty Joan said as she settled herself in the high-backed chair, "It's like pea soup out there."

"The fog was already bad when I was coming home from school," Louisa said, adjusting her position slightly on the sofa to accommodate the nursing baby.

"Well, it's certainly worse now." Joan replied. "I could barely see the road on the way here. It's going to be miserable if it doesn't lift before dark."

Joan had insisted on coming over on Louisa's first day back at school. Martin had tried to discourage her – he suspected Louisa would be exhausted and having to entertain even a well-meaning relative would only be an added burden.

Now, sitting next to the mother of his son, his fears were confirmed. Louisa looked drained, which wasn't surprising given that she'd awakened before six to feed the baby and pump breast milk for the day and hadn't arrived home until well after five. She'd spent the last two hours bathing and changing Tommy and then picking at the dinner Martin had prepared. When he'd gently berated her for not eating, she'd snapped at him.

"I'm not hungry, Martin."

"Louisa, you need to eat. If you don't like what I've prepared, I can fix you something else—"

"There's nothing wrong with the meal. I'm just not hungry right now!"

In the end, she'd gotten up from the table having eaten almost nothing that was set before her.

Joan, unaware of all that had gone on before she'd arrived, hadn't picked up on their bickering. "How did it go today with Tanya?" she asked, taking a sip of coffee.

Martin shrugged. "It was all right," he said. He'd insisted on staying home on the nanny's first day to ensure everything went well – or at least that nothing went wrong. Despite his initial reservations, he had to admit that the young woman they'd hired seemed to know what she was doing.

"So you're back in Truro tomorrow?"

"Yes." Which meant it would be the first day they left Tommy alone with the nanny. Joan had promised to be available if any issues arose but Martin knew the prospect of leaving their son alone for the first time had both him and Louisa on edge.

Outside, there was a flash of lightning followed a few seconds later by a crack of thunder.

Tommy had pulled away from Louisa's breast, refusing her attempts to get him to continue nursing. "He's hardly taken any milk," she complained. "And he barely nursed this morning either."

"It's all right," he reassured her. "He ate well during the day."

"But he's not taking it from me."

Joan stood up and walked over to them. "Louisa, you've had a long day. Why don't you let Martin and me get Tommy ready for bed."

"I'm his mother; I should do it."

"Nonsense!" Joan said. "It's your first day back at school. Let yourself rest a bit."

She shook her head defiantly. "I need to do my lesson plans for tomorrow and review the schedule for parents' night." Nonetheless, she didn't protest as Joan took the baby from her.

"Which you can do better," he urged, "after you've had a short rest."

"Will everyone stop telling me to rest!"

"We're telling you to rest because it's good for you," he said. "You're barely over your mastitis; you shouldn't be putting in full days yet."

"Martin, I don't need you constantly being my doctor and I don't need either of you telling me what I should be doing."

Before he could respond, his mobile rang. He frowned. One of the few advantages of being a consultant in Truro was not having to be on call twenty-four hours a day. When he left the hospital, he was finished until his next shift. Moreover, the two people most likely to call him, Louisa and Joan, were both here. Who else would be phoning him, especially at this hour?

"Ellingham," he answered brusquely.

"Martin? It's Geoff Owens. I'm at the surgery. There's a patient here with what I think may be a surgical abdomen. Probably appendicitis but I'm not sure." Owens' words were coming out in a rush. "I don't know whether to call for the ambulance or an air ambulance and, given the weather—"

"Owens!" he said sternly. "Slow down!"

Through the phone, Martin heard the man take a deep breath.

"I know I have no right to ask," Owens said, "but I'd appreciate a surgical consult."

"You're well aware that I'm no longer a surgeon," he said, not attempting to mask the bitterness in his tone.

"Okay, you _were_ a surgeon which means you're a lot closer to being a surgeon than I'll ever be. Please. I don't know what to do."

Martin heard the panic in Owens' voice, looked over at Louisa and Tommy, and sighed heavily. Owens wasn't a complete fool and probably wouldn't call him, of all people, if the situation weren't serious.

"All right," he said. "I'll be there as soon as I can."

After making apologies to Louisa, and obtaining a promise from Joan to make sure Louisa got to bed early, Martin reluctantly headed for the surgery. It was a night straight out of one of Arthur Conan Doyle's Sherlock Holmes novels – weather more suited to London than Cornwall. Even with the xenon headlights of the Lexus, Martin had to drive much more slowly than usual, as the thick fog made it difficult to see more than a few feet ahead of the car. That, along with the rain – more of a stinging mist than pelting shower – turned what should have been a five-minute journey into a trip more than twice that long.

The best thing about arriving at his former office for the first time since he'd closed the door for good several weeks ago was that he didn't have time to reflect on the moment. The front door was unlocked and he walked through the waiting room without making any effort to notice the many changes he'd heard so much about.

At this hour, the patients and Poppy were long gone and the lights dimmed, which combined to give the office a dark and desolate feel.

Owens met him at the door to the consulting room. "Thanks for coming. I really appreciate—"

Martin had no desire for small talk. "Tell me about the patient."

"Eighteen-year-old girl complaining of abdominal pain in the lower right quadrant. I'm thinking appendicitis but I'm not sure."

"Why?"

"Why what?"

"Why are you unsure?" Martin asked in the tone he'd so frequently used with his surgical registrars.

"Well, the pain's where you'd expect with appendicitis but she's also presenting with acute onset, normal temperature, pronounced bowel sounds, and she says that the pain has remained consistent in the right quadrant."

Owens was correct in that all of those symptoms were contraindications for appendicitis. Nonetheless, Martin knew from experience that appendicitis often presented atypically, which was why the condition was so difficult to diagnose, especially in young women.

"Did you ask about pregnancy?" he asked.

"Of course I did. She denied it. I've just phoned for an ambulance but they're really backed up with this weather."

It was a wise precaution. "All right, let's see her."

Inside the consulting room, Martin had to pause for a moment to get his bearings. Although everything was more or less in the same place as when the office had been his, Owens had chosen a more traditional wooden desk, which was placed at an angle in the corner, and the new examination couch reminded him of the modern, padded ones provided in the consulting rooms at the hospital in Truro.

He immediately recognized the patient. It was Mandy Jordan, who'd come to him a few years ago looking for estrogen or anything else that would magically increase the size of her breasts. In a moment of weakness – or perhaps insanity – he'd given her a placebo consisting of Poppy's peppermints. He'd seen her infrequently since that day and often wondered if she'd ever guessed what he'd done.

She gazed up at him, pale and with pain etched in her features but nonetheless managing a tight smile. "Doc Martin. What are _you_ doing here?"

Martin grimaced slightly at the nickname but Owens spoke up first. "I've asked Dr. Ellingham to take a look at you."

Mandy turned her gaze to the GP. "I thought you said I have appendicitis."

"I said you _might_ have appendicitis," Owens corrected. "Dr. Ellingham's had a lot of experience with this sort of thing so I thought it best to get his opinion as well."

Martin stepped forward and took her pulse at the wrist. "When did the pain start?"

Mandy looked away. "I've had bad cramps for a couple of days but today it really started hurting bad. I about fainted at the cinema and Doc Owens said to come straight here."

He turned to Owens. "What's her BP?"

"110 over 70 when she came in."

"Take it again." He turned back to Mandy, pulled up the gown and gently probed her abdomen.

"Oh!" she cried and, when he reached her right side, twisted away. "That hurts. That really hurts."

"Sorry," he absently, focused intently on his examination. There was significant abdominal tenderness in her lower right quadrant but also an absence of guarding or rebound tenderness.

"Have you had any vaginal bleeding?" he asked as he pulled the gown back into place.

She sucked in a few shallow breaths and nodded.

"When was your last menstrual period?"

She stared at the far wall. "Does it matter?"

"I wouldn't ask if it didn't."

She turned back to him. "I'm a bit late, all right? Can't you give me something for the pain?"

"Not yet," Martin said. In cases like this, any change in the intensity or location of pain could be an important diagnostic tool. "How late is 'a bit' late?" he asked.

"Couple weeks."

Damn.

"BP's 108 over 72," Owens reported, pulling the stethoscope from his ears.

Not too bad, considering. Martin leaned in close. "Mandy, is there any chance you could be pregnant?"

Mandy, clearly ill at ease, blinked rapidly. "No. Dr. Owens already asked me that."

Martin exchanged a glance with Owens. He was sure the man had asked but had he asked the right question? Martin turned back to Mandy. "Think back six or eight weeks ago – early June. Did you have sexual intercourse then?

She paused, biting her lower lip.

Martin used his surgeon's commanding tone. "Mandy, I'm going to help you but you must tell me the truth. It's very important. Did you have sex in early June – even one time?" When she didn't answer, he spoke more firmly. "Mandy, you need to tell me."

Slowly, hesitantly, she nodded. "Yeah."

He wasn't all that surprised. "Were you taking oral contraceptives or was your partner using a condom?"

"No." Her voice was nearly a whisper.

Martin gazed out the window at the thickening fog and blew out a long breath. "Mandy, you rest there," he said. "We'll be right back."

He motioned Owens to the waiting room, took off his jacket and started to roll up his sleeves. It was going to be a long night.

"I take it you two have a history," Owens said, glancing back through the open consulting room door.

"Former patient," he replied cryptically.

"Oh. So, what's your impression?"

"I think she may have an ectopic pregnancy." Which meant they were potentially facing a medical emergency.

Owens frowned. "At her age? It's highly unlikely."

"I know, but her symptoms make it much more likely than appendicitis."

"What about an ovarian cyst?"

"It's possible," Martin conceded. The symptoms of a cyst largely mimicked those of a tubal pregnancy and were more common in someone Mandy's age. "But I think it's an ectopic, which means we need to get that ambulance here immediately."

"I still say an ovarian cyst is _much_ more likely. And, if that's what she has," Owens emphasized, "then there's no emergency."

Even though everything Owens said made perfect sense, Martin had seen his share of surgical abdomens as a house officer and registrar and this one seemed to have the makings of a tubal pregnancy. "She'll need a pelvic exam and a pregnancy test – that will give us a better idea of what we're dealing with."

"I agree. Want me to do it?" Owens asked.

Martin shook his head. "No, I'll do it." Actually, he'd prefer to let Owens do the exam if for no other reason than Mandy was technically his patient. However, Martin worried that if things got worse over the next few hours, he'd need a first hand assessment of the girl's anatomical landmarks.

"You," he added, "check on that ambulance."


	16. Chapter 16

Back inside the consulting room, Mandy's nervous eyes followed him as he stripped off his latex gloves and tossed them in the waste bin.

'That's all," he said. The examination had been diagnostically productive but had been extremely uncomfortable for his patient.

"So, do you know what's wrong with me?" Mandy asked.

"I think you have an ectopic pregnancy," he said, stepping next to the bed and looking down at her. "Do you know what that is?"

Her eyes widened and she shook her head. "I'm pregnant?"

Martin sighed. "Yes. But," he held up a hand. "In an ectopic pregnancy, the embryo implants itself in your fallopian tube instead of your uterus." He could see from the blank expression on her face that she wasn't following his explanation. "The fetus – the baby – starts to grow in the wrong place in your body."

"What does that mean?"

Martin sighed. "In an ectopic pregnancy, the fetus can't survive. We need take you to hospital and they'll perform an operation to . . . remove it. It has to be done."

She seemed to consider that for a moment. "Will you do it?" she finally asked. "The surgery, I mean."

"No. You'll have a specialist."

"I wish it was you."

"Thank you." Martin hoped he hadn't flushed. "Um, I mean, you'll be in good hands."

"Doc, can I ask you something?"

"Yes, of course."

"When you gave me those pills, for my tits, the ones that tasted like mints, they _were_ mints, weren't they? Just mints." 

Martin stared into her eyes for a minute and the let out a breath. "Yes, they were. I knew how important it was that—"

"It's okay." She cracked a tiny smile. "Took me months to figure it out. You see, my tits never really got bigger, but by then it didn't matter—" She grabbed at her abdomen. "Oh, god, it hurts. Make it stop."

Seconds later, he pushed open the door to the waiting room, where Owens was finishing a conversation on his mobile. Owens cut short the call and looked up at him expectantly.

"There's vaginal bleeding and a mass in the right adnexal region," Martin reported. "And the pregnancy test was positive." He stared out the window where the lights were dim in the fog and rain continued to streak down the glass. They needed the speed of the air ambulance, but a helicopter was out of the question in this weather.

"How long until the ambulance gets here?" he asked.

"At least an hour."

"That's too long."

Owens shrugged in apology. "The dispatcher said both ambulances are out on other calls – MI and vehicle trauma. They'll send the first one that's available."

"Given her symptoms, I'm concerned about rupture."

"Maybe we should just drive her to Truro."

Martin shook his head. "If she ruptures in the car, we can't do a thing. At least here or in an ambulance, there's a chance."

"I'll call them again – make sure they understand the urgency of the situation."

"Tell them to bring plasma and at least two liters of O-negative blood. And a field surgical kit."

"A surgical kit?" Owens was clearly shocked. "Surely you're not planning to—"

Martin gave him a sharp glance. "I hope not."

"Martin, you can't! This isn't a hospital. If it's an ectopic, we're talking major surgery."

"I'm well aware of that."

"Which even you can't perform in a consulting room."

Martin gave him an annoyed look. "Just have the ambulance bring the kit."

Owens ran a hand through his hair. "I already have one."

Martin's eyes narrowed. "You do?"

"It was a gift from one of my partners when I left the group practice in Dorset. They said that I'd need it when I was finally out on my own . . . kind of a running joke," he finished lamely. "I've never actually used it, of course."

Martin was familiar with these kits; they contained the basics – scalpels, hemostats, pickups and scissors. Not ideal, but it might do. "I'll have a look at it."

"Even so, I don't have any anesthetic other than lidocaine," Owens added.

"Understandable." Martin rubbed his eyes. If the worst came to pass, he'd need something stronger. Where would he find it in Portwenn? It was unlikely Mrs. Tishell could help. The veterinarian might have something but he lived only a few miles from Truro – too far to be useful.

There was something . . . "Owens, what about that dentist? The one who was on the radio the other day talking about sedation dentistry."

"Bill Richards."

"Right. Call him. See what he has." Martin looked back into the consulting room. "In the meantime, we need to get a line in her – get some fluids going. Do you have any saline?"

Owens seemed to relax a bit at the change in subject. "Yeah, plenty. And a couple of bags of haemaccel."

"Good." A surgery stocked with a surgical kit and IV fluids. Martin's view of Owens was rapidly improving.

"Ellingham!" Edith answered his call with obvious surprise. "Where are you? Are you here in London?" 

"No. I'm in Portwenn; I need your help with a patient." The last thing Martin had wanted to do was call Edith Montgomery. As far as he was concerned, that part of his life was now officially over and he had no desire to see or speak to her again. Nonetheless, she was an extremely competent GYN and, at the moment, he needed that expertise.

"Portwenn?" she asked, disparagement evident in her tone. "Whatever are you doing back there?"

"I have a patient here in the surgery," he said, ignoring her question. "Eighteen years old with an ectopic pregnancy. I fear she's near rupture."

"So why are you calling me? Put her in the ambulance and, when she gets to hospital, the GYN will take care of it."

"The ambulance," Martin enunciated carefully, keeping an eye on Mandy, "is forty minutes from the surgery and, as you know, the trip to Truro is at least an hour. She'll bleed out by the time she gets there."

"Haven't you heard of an air ambulance?"

There were times where Edith could be infuriating and Martin was beginning to wonder whether calling her had been a huge mistake. "The fog here's too thick for it to land. I need to know what to do if she ruptures."

"You're not thinking of surgery are you?" she asked somewhat incredulously. "Are you even sure it's an ectopic?"

"I'm not calling to debate my diagnosis."

"But you can't be certain without an ultrasound."

"Which we don't exactly have here," he pointed out.

"Ellingham, you're insane. I can't believe you're even considering performing a laparotomy in your surgery on a patient without even a definitive diagnosis."

It's no longer _my_ surgery, he said to himself. To her, he simply said, "Edith, either tell me what I need to do or get off the line."

She sighed heavily. "All right, Ellingham, it's your medical license. What supplies do you have?"

"Field surgical kit, saline and haemaccel, lidocaine and probably propofol. And the GP here as an assistant."

"Well, that's something. What about blood?"

"Not yet. The ambulance is bringing it."

"Okay. If you insist on doing something stupid, I recommend a mini-laparotomy – takes less time, minimizes blood loss and you don't need the fancy retractors that you undoubtedly don't have. You'll want to use a transverse suprapubic incision and then open the abdomen using Cohen's technique . . ."

"Doc? Doc Martin?" Mandy's voice from the examination couch sounded feeble.

Martin glanced at his watch. He'd just finished the call with Edith. About half an hour had passed since Owens had last spoken to the dispatcher, which meant that the ambulance was about thirty minutes away. Owens had also spoken to the dentist, who lived only a few minutes from the surgery and indicated he had IV propofol on hand. It was as good as he could hope for.

Martin quickly stood up from the chair, stepped over to her and frowned. He could have sworn she was more pale than when he'd checked her fifteen minutes ago. She also seemed to be shivering. "Yes, Mandy."

"I'm cold," she said, "and my stomach _really_ hurts."

Martin grimaced and checked her pulse at the neck and then at the wrist. It was fast – about 130 beats per minute – and her hand was like ice. She was going into shock.

"Owens, get her BP."

The younger doctor jumped up from his chair and grabbed the BP cuff.

Martin pressed gently on Mandy's lower abdomen. Even with minimal pressure, she cried out at the first touch and, when he pushed a bit deeper, nearly came off the table. "Oh, God. That hurts!"

"BP's 80 over 60," Owens reported.

"Mandy, do you have pain in your shoulder?" Martin asked, lifting it slightly.

"Shoulder?" Owens asked from across the table.

"The ectopic could well be pressing on the diaphragm," he explained, "which in turn causes referred pain in the shoulder."

She groaned slightly at the touch. "Yes, but it's my stomach. Please help me!"

"I will."

Martin tilted his head to motion Owens to the far side of the consulting room. "She's rupturing," he said without preamble.

"Shit. What are we going to do?" This time it was Owens who checked his watch. "The ambulance is still half an hour away, if it's even on time."

Martin glanced back at the patient. Her skin was cold and clammy, pulse was weak and fast, and BP was falling. He checked the IV – still half a bag to go. He'd need to increase the flow rate to stabilize her in the face of internal bleeding.

"Let's start a second IV with the haemaccel, wide open. We've got to combat the shock."

"I'm on it." The younger man started pulling supplies from his cabinets.

Martin again checked Mandy's blood pressure as Owens expertly inserted the second line; the BP was still low but holding. However, the girl was becoming agitated and her eyes had trouble focusing.

Suddenly, her body seemed to go limp. He moved back to the bed, took Mandy's face in his hands and searched her pupils. "Mandy, can you hear me? Mandy!" He grabbed her shoulders. "Mandy! It's Dr. Ellingham. Look at me!"

"Mints," she mumbled.

He frowned and leaned closer. "What?"

"Just mints." Suddenly, her eyes rolled back in her head.

"Mandy!" His fingers pressed against her carotid. Even without checking the rate against his watch, he felt her pulse racing.

Across the table, he heard Owens pumping the sphygmomanometer. "BP's 80 by palpation."

"She's bleeding out," Martin said, just as he had about Peter Cronk several years ago. Only this situation was much more desperate.


	17. Chapter 17

Someone suggested that definitions of the medical terminology used in my story would help. So, here goes for this chapter. PLEASE NOTE: I'm not a medical professional; the below are a layperson's explanations designed to help readers understand my story; they are not necessarily the technical, medical definitions

Betadine: the brown stuff used to cleanse/disinfect skin for surgery

Exsanguinate: bleed out, bleed to death

Rectus sheath: the connective tissue that surrounds the rectus abdominis muscle

Peritoneum - lining that covers the abdominal cavity

Haemaccel: an IV fluid used to combat shock; it's what was used in the Peter Cronk surgery

* * *

"Get that dentist here now!" Martin ordered, stepping to the counter and grabbing the surgical kit. "And then get her lower abdomen prepped."

Owens eyes were wide. "You're not really thinking of—"

Martin nodded. "Yes."

"You can't perform a laparotomy _here_. This is a doctor's surgery, not a hospital."

"I'm keenly aware of that."

"You said yourself that we don't have the proper equipment or anesthetic—"

Martin was quickly losing his patience. "It'll have to do."

"Have to do? Since when do we make do with our patients?"

"When it's the only chance we have of saving their life."

"Perfect," Owens replied sarcastically. "Just perfect. And what about your hemophobia? What if you pass out in the middle of the damn operation? Do you expect me to just jump in and finish things up?" he asked, voice rising in anger.

"You needn't worry about that," Martin replied with more conviction than he felt. He'd made it through Peter's emergency surgery, he tried reassuring himself, he could endure this as well.

"No! I'm not going to let you perform major surgery in _my_ consulting room."

"Then what would you have me do?"

Owens hesitated. "The ambulance is on its way."

"Look at her!" Martin said, pointing to Mandy, now almost unconscious. "Her BP's almost unreadable, her heart rate is through the roof, she's in shock and bleeding internally. She's not going to last the ninety minutes that it will take to get her to Truro."

"You don't know that."

"Of course I know it – as do you. Now either you call that dentist or I will."

Owens glared at him and then angrily punched his mobile. The conversation was short with the dentist agreeing to be there in less than ten minutes.

"Where's your betadine?" Martin asked, opening cabinet doors at random.

Owens stepped in front of him and slammed one of them shut. "Listen to me. What you're considering is absolute insanity. You know that, if you operate under these conditions and something goes wrong, we could both lose our medical licenses."

"If I don't operate, she is _definitely_ going to die." Martin opened a drawer and removed a packet with sterile gloves. "She's your patient. What do you want to do? Stand here and watch her exsanguinate or help me save her life?"

* * *

Martin stared down at Mandy's exposed abdomen. She was now unconscious, having been given IV propofol for sedation and lidocaine for analgesia, and the dentist had agreed to monitor her vital signs during the surgery.

Unlike when he'd performed the impromptu surgery on Peter Cronk, this time he'd actually been able to spend a few minutes scrubbing up, the first time he'd done so for a surgical procedure since he'd left London. The routine - even though abbreviated - was both eerily familiar and strangely frightening. The surgery on Peter had been virtually a split second decision – something he'd done almost on impulse because it seemed the only means to save the boy's life. This time, Martin had had the time to consider his plans and even debate them with a colleague.

"I still think this is a big mistake," Owens now said from across the table.

Martin had had enough. The surgery would be difficult enough without having to argue with his erstwhile assistant every step of the way. "Look, Owens." He was angry and didn't care. "Either shut up and help or leave. But do one or the other. Now!"

Owens held up his own gloved hands. "All right. I was just expressing my opinion."

"Don't."

He took the scalpel from the surgical tray and held it in his hands, mentally steeling himself for the steps to come. Surgery for a ruptured ectopic would be bloody as hell – far worse than Peter Cronk or anything he'd seen since his days as a surgeon. He could only trust that all of the desensitization training he'd endured for the past weeks would see him through. After insisting on this surgery, he dared not vomit – or worse, faint – in the middle of it. More importantly, if Mandy were to have any chance of surviving, he needed to call on all of the skill and focus that had made him a respected Chief of Surgery.

"Vitals?" he asked, forcing into his voice a calm he didn't quite feel.

"BP's 70 by palpation," the dentist reported. "Pulse 132, respirations 16."

Mandy's condition wasn't improving. It was time to get started. Martin took a deep breath, set the scalpel against the betadine-stained lower abdomen and pressed the blade firmly into the skin.

Blood poured out of the incision and it was all Martin could do to keep his eyes on the wound and the bile in his throat. Breathe in and out, he reminded himself. In and out. Even so, the smell of the blood was overpowering and he needed to breathe through his mouth to avoid retching from the stench.

Owens immediately cleared away the surface blood, as Martin pushed his gloved fingers into the incision. His own pulse was racing and he felt the familiar beads of sweat starting to pool on his forehead. Breathe in. And out.

The way to get through this, he told himself, was to focus on the technical aspects of the procedure. He might be an experienced surgeon, but he hadn't done GYN surgery since his first days as a house officer. He needed to concentrate fully on each surgical step Edith had described.

"You all right?" Owens asked, eyebrows knitting in concern.

Martin met his eyes across the table. "Fine," he said, struggling to keep his voice steady. "Just . . . keep the field clear."

He moved deeper into the abdomen, tearing the rectus sheath and then opening the peritoneum with his fingers. The technique bordered on barbaric compared to what he'd been used to in London but – as he and Edith had discussed – it was the best he could do here given the circumstances.

The abdominal cavity was filled with blood and Owens was fully occupied keeping the sponges coming and the surgical field clear. The GP was, Martin had to admit, a competent assistant for someone who'd never trained in surgery.

Within minutes Martin was able to expose the uterus and feel his way to the right fallopian tube. He pulled the small organ outside of the abdominal cavity held it out for Owens to see. There was no question that this was a tubal pregnancy.

"You were right," Owens said with a sigh, tossing aside another sponge. "Damn."

Before he could take credit for the accuracy of his diagnosis, the dentist's voice cried out in alarm. "BP's falling! Down to 60 by palpation."

Shit. The blood loss was finally taking its toll. They needed to transfuse her and, at the moment, they had no blood or even plasma.

"Hang another unit of haemoccel," Martin said. "Pump it in." He kept his voice level, as he had for so many years in the operating theatre. The last thing they needed was panic.

Owens gave him a scared look. "That's not going to work!"

"It'll have to do until the ambulance gets here."

There was no going back – his only option at this point was to continue with the surgery and hope for the best. He held out his free hand. "Clamp."


	18. Chapter 18

Medical glossary

Hemostat: basically a clamp, used in surgery to control bleeding

Mesosalpinx: broad ligament of the uterus enclosing the fallopian tube

* * *

Owens quickly slapped a surgical clamp and then another and then another into Martin's open palm. Holding the ectopic in one hand, Martin used the hemostats one at a time to clamp across the blood supply to the right fallopian tube.

"I just need to . . . clamp off . . . the mesosalpinx." Martin forced his voice to remain measured. It was the critical step in the surgery, cutting off the blood supply and stopping the hemorrhaging from the inflamed tube.

Having spent his career working on arteries and veins, pelvic anatomy was more foreign than he would have liked, and he could only hope that he was following Edith's instructions correctly. The last thing he wanted to do was cut the wrong piece of Mandy's anatomy.

Martin waved off another proffered hemostat. "That's enough. Here we go," he said, carefully placing the final clamp and noting with satisfaction that, almost immediately, the final bit of bleeding stopped. Plenty of blood remained in the abdominal cavity but at least the source of fresh bleeding had been cut off.

"How's she doing?" he asked, stealing a look at the dentist sitting at Mandy's head.

"Haemaccel's mostly in. Pulse is down to 120. BP's now 80/60."

Across the table, Owens exhaled loudly. "Whew."

So far so good. Nonetheless, Martin had no illusions that they were out of danger. Mandy's vitals were unstable, her gut was open, the surgery wasn't finished, and they still had no means to replace the substantial blood loss that had already occurred. The patient was critical and there was still far too much that could go wrong. And where was that damn ambulance?

"Do you have any more fluids?" Martin asked.

"There's one more bag of saline," the dentist replied.

"Hang it when the haemaccel's finished and run it wide open," he said, then returned his attention to the surgery at hand.

The next step was to excise the clamped-off tube and enclosed ectopic pregnancy and get it out of her body. He turned his attention back to Owens. "Pickups and scissors."

A loud clatter came from the area of the waiting room.

"Hello!" an unfamiliar voice called out. "Anyone here? Did someone call for an ambulance?"

"In here!" Owens shouted.

"Pickups and scissors! Now!" Martin demanded, hands held out and eyes never leaving the surgical field. An instant later, he felt the slap of cold instruments into his gloved hands.

Out of the corner of his eye, Martin saw the door to the consulting room open and two ambulance techs, a man and a woman, start to rush in. They stopped inside the doorway, eyes wide and mouths agape.

"What the hell-?"

"Did you bring the blood?" Martin asked.

"Uh, yeah," the male tech said. "It's in the ambulance." He took a step closer to the exam table. "What the hell are you doing?"

"What does it look like?" Martin replied. "We need that blood now." His eyes flicked to Owens, then stared down into the open wound where his fingers were pulling out the damaged fallopian tube.

"Get me something to put this in."

Almost immediately Owens held out a steel basin, into which he dropped the excised tissue.

The female tech came back into the room, a pint of blood in hand. "Here you are. O-negative."

Martin blew out a long breath. "Owens, get the transfusion going. I'll clean out what I can and get her stitched up."

Martin's surgical mentors would have taken him to the woodshed for the hasty and somewhat messy job he did of clearing the abdomen of the clots and loose blood and sewing up the wound. It was nothing like the precise work he did in cleaning out and suturing together tiny arteries.

Still, he'd finished the operation and the patient was alive. Mandy's vital signs, while lower than he would have liked, had stabilized. Given what he'd had to work with, that was something.

Most importantly, he'd made it through the surgery without vomiting or fainting, or really even coming close to either. In fact, once he'd gotten through the initial moments of the operation, he'd almost forgotten about his phobia. He wasn't sure whether it due to the desensitization exercises or the simple fact that, had he faltered during the surgery, Mandy would certainly have died. Whatever the reason, he was both relieved and grateful. And exhausted.

Martin remained concerned about the long trip to the hospital that still lay ahead. The hastily placed sutures could easily rupture and cause renewed hemorrhaging. In the ambulance, that could well be fatal.

"That was . . . really impressive," Owens said, wiping his hands on a towel as the medics bundled Mandy onto their stretcher.

"Careful with the IVs," Martin cautioned, shepherding their every move. For once, the attendants didn't give him some snappy retort.

"What I'm trying to say," Owens added, "is that if you hadn't been here . . ."

"I am here, because you called me."

"But I could never have—"

Martin shook his head. "Not now."

"I can't ever thank you enough."

"Probably not."

"Is one of you coming with us?" the male ambulance attendant asked, looking between the two doctors. The man was clearly not anxious to make the trip alone with this patient.

Martin, now washing his owns hands at the sink, turned to Owens. "Your call."

The younger man ran a hand through his hair and chewed on his lower lip. "I think it's best that you go. I'm . . . not equipped to handle . . . if something goes wrong."

"Right."

"Good news, Doc," the attendant said as they walked outside to the ambulance. The rain had abated and the fog didn't seem quite as dense as when he'd entered the surgery more than a long hour ago. "Dispatch says there's a pocket of clear air about ten miles from here. They think they can land the helicopter."

Martin sighed with relief as he climbed into the back of the ambulance and slid into the seat next to Mandy's stretcher. "Let's go."


	19. Chapter 19

"How long have you had the jaundice?" Martin asked mechanically. The patient, a twenty-five year-old young man, and his symptoms were marginally interesting which was about the only thing keeping Martin from falling asleep at his desk.

He'd flown to Truro hospital in the helicopter with Mandy, staying with her until he was sure the girl was out of danger. He'd discovered that one advantage to being a consultant at the hospital was that, this time, he wasn't forced to stay outside the treatment room, waiting for one of the house officers to bring him news of the girl's condition. As a result, he didn't crawl into his hotel bed until after four in the morning, waking up to the annoying sound of the alarm only two hours later.

Now, after nearly a full schedule of patients, Martin was starting to feel the effects of the past twenty-four hours. He pinched his eyes closed and forced himself to concentrate on the patient now sitting in front of him.

"How long have I had what?" his patient asked.

"Jaundice. The yellow tinge to your skin."

"I hadn't really noticed. It's my stomach that hurts."

"All right. Lie down on the exam couch and undo your belt."

Palpation showed hepatomegaly – an enlargement of the spleen that could signal hepatitis or even mononucleosis. However, the patient's GP had already considered – and ruled out – those diagnoses, which is why the man had been referred to him.

"Sit up," Martin ordered when he'd finished. He stepped to the desk and retrieved his ophthalmoscope and stared into the patient's eye. "Look straight ahead." Yup, there is was: the brown, ring-shaped color in the cornea, known as a Kayser-Fleischer ring.

He snapped off the light. "I'm going to send you to the laboratory for some blood tests. You may need a liver biopsy."

The man gave him a curious look. "A biopsy. What've I got? Cancer?"

"No. Wilson's disease. It's a hereditary condition in which your body retains too much copper. The copper accumulates in the liver causing symptoms similar to hepatitis. Once the diagnosis is confirmed, I'll start you on medication to rid your body of the excess copper."

He scribbled his signature on the requisite forms. "Take these to the laboratory. They'll send me the results and I'll give you a call." He punched the intercom. "Next patient."

"Wait a second!" the patient said. "Am I going to be okay?"

"Yes. Next patient!"

There was the now-familiar sound of the door to the consulting room opening. Martin continued writing up the patient notes. "Take a seat," he ordered, without looking up.

"Do you greet all your patients that way?"

"Huh?" he raised his eyes, frowning when he saw the person standing in front of him.

"They said you had a cancellation," Geoffrey Owens said, dropping into the chair. "I hope you don't mind."

"Of course I mind." He peered closely as the GP. He looked even more tired than Martin felt and his eyes were bloodshot. "Have you been drinking?" he asked.

Owens shrugged. "Does it matter?"

"Only if you plan to drive a car or see patients."

"Well, if it makes any difference, I'm stone cold sober. Just didn't get much sleep last night."

Martin leaned back in his chair. "So why are you here?"

"I checked in on Mandy. They said she's doing very well, all things considered."

"Yes."

Owens rested his elbow on the arm of the chair and cupped his chin in his hand. "I've done a lot of thinking since last night."

The remark didn't seem to call for an answer, so Martin simply waited for the man to continue.

"If you hadn't been there, Mandy would have died."

Martin sighed. "We've been over that."

"Martin, she would have _died_. And I would have had to live with that." He paused. "I can't live with that."

"Regardless of what we do, patients die. As doctors, we all have to live with that."

Owens leaned back in his chair. "I've been a GP for nearly ten years but, until I came to Portwenn, never on my own. I've always had partners to consult with. Now, there's only me."

"It can take some . . . adjustment."

"Adjustment? You were a surgeon, for god's sake; I was already a GP. If anyone had an adjustment to make, it should have been you. And yet you don't seem to have any problems."

Martin was tired and his fatigue was manifesting itself in impatience with this conversation. "Owens, what do you want from me? I do have actual patients to see."

"I'm not sure I'm cut out to be the GP in Portwenn," Owens blurted out.

This was . . . unexpected and Martin simply stared back at him for a few seconds trying to decide how best to respond.

"And you've come to this conclusion after only three weeks?" he finally asked.

"You decided to turn down the position at Imperial in much less time."

Touché. "That was . . ."

"Different?" Owens finished. "The reason, maybe." He shrugged. "I only know that I quit something I was quite good at in favor of a position for which I'm obviously not well suited."

"From what I hear, the town is quite pleased with its new GP."

"Probably because I offer magazines and serve tea." Owens said sarcastically.

"Don't sell yourself short," Martin replied sharply. "It can take a bit of time to . . . get settled."

"It's not about being settled. It's about being the doctor my patients need me to be."

Martin wondered how much of Owens' self-deprecation was due to his exhaustion. "Look, Owens, we've both had a long night. This probably isn't the best time to make career decisions."

"I'm not the diagnostician you are and never will be. That fact isn't going to change."

Martin wasn't quite sure what to make of the compliment. He'd always thought about his medical career in terms of his surgical abilities, or lack thereof. Not to mention that he'd had his share of diagnostic missteps during his time as the Portwenn GP. "It's not a competition," he said.

"No, it isn't. But for the first time in my career, I find myself questioning every decision and diagnosis. Did I get it right? What would Ellingham have done? And, if I'm doing it, the patients probably are as well."

"I sincerely doubt that." After all, Martin reflected, these people considered the grossly incompetent Dr. Sims to be an acceptable GP. Owens was a sight better than that.

"Martin, whether you're physically in Portween or not, I'd always be working in your shadow and that's something I can't do . . . and don't want to do."

Whatever. Martin decided that it wasn't his place to argue with the man nor, at present, did he have the energy or interest in trying. Let Chris Parsons talk Owens out of his decision, if that's what the PCT thought best.

"So what _will_ you do?" he asked automatically, not that he really cared.

"Find a group practice, in Cornwall perhaps. Don't get me wrong, I love being a GP, especially in a place like Portwenn. Far as I'm concerned, it's the best job a doctor can have. You get to know your patients and they get to know you. You care for them as people."

Martin could only roll his eyes.

Owens laughed softly. "All right, I won't try to convince you, you being a surgeon and all."

Martin waved his hand at the contents of the GP consulting room. "I'm not a surgeon."

"Could have fooled me last night. And, at some level, you'll always be a surgeon. The irony is that you're probably a even better GP than a surgeon."

Martin frowned at the comment. As far as he was concerned, being a GP simply wasn't that difficult, so being good at is wasn't a noteworthy accomplishment. As Edith had so recently and succinctly reminded him, he was capable of so much more than . . . this.

Owens was still talking. "Not to mention that you have in Louisa a beautiful woman who adores you, a son who'll someday dote on you if you'll only let him, and a surgery full of patients who like and respect you, even if they're too stubborn and obstinate to admit it. And the crazy thing is that you're so busy trying to recapture something that once was that I don't think you even realize, let alone appreciate, what you already have."

Martin bristled at the lecture. "Are you here to engage in mindless psychobabble or do you have something relevant to say?"

Owens stood up. "Right. Well, you certainly aren't looking for advice from me. I only came here to thank you again for your help last night and to tell you that the GP spot in Portwenn will be opening up soon." He stopped at the door without looking back. "Not that you'd be interested, of course."


	20. Chapter 20

"I still can't believe it." Chris Parsons stared at him across Louisa's living room in undisguised admiration.

Martin walked over him, poured merlot into a wine glass and placed it in front of him on the sofa table. He raised his eyebrows. "You can't believe what?"

"That you repaired a ruptured ectopic pregnancy – a procedure you'd never done before – in a consulting room with a field surgical kit, a non-surgical assistant and a dentist providing the anesthesia. There probably aren't fifty surgeons in the UK who'd be capable of such a thing and most of those wouldn't have had the guts to even attempt it."

Parsons took a sip of the wine before continuing. "And then to have it turn out so well; as I said, I can't quite believe it."

Martin couldn't help but suppress a smile. He'd been the talk of the hospital in Truro over the past couple of days. Half the people thought he was a hero for what he'd done; the other half clearly thought him an idiot for even attempting it. His only regret had been being the subject of conversation; he could have cared less what they said. Chris Parsons was an exception; as a colleague and a friend, his opinion mattered more than Martin cared to admit.

"I'm sure Portwenn's quite abuzz," Parsons added.

"It doesn't take much for that to happen," Martin responded drily. "Besides, I was only doing my job.

"Oh for god's sake, Martin, give yourself some credit. Not to mention that the last time I checked, it wasn't even _your_ job." He took another drink of wine. "Speaking of which, I assume you've heard that Owens is looking to leave."

"So he informed me the other day. I told him he's a fool."

Parsons raised his eyebrows. "Why's that?"

"That he's a fool or that I told him such?" Martin asked as he took a seat across the room. Through the ceiling he could hear the sounds of Louisa getting Tommy ready for bed.

Parsons gave him an amused look. "Both, I suppose."

"He's a competent enough doctor. There's no cause to quit before he's barely started."

"Maybe he's not up to the competition."

Martin noted with irony that this was the same term he'd used the other day in his conversation with Owens. "What competition?"

"You, Martin. Very few people can be you."

"Very few would want to be, I'd say."

Parsons sat forward on the sofa and rested his hands on his knees. "Martin, I know that you consider your skills wasted here and I've no doubt it's galling to see idiots like Adrian Pitts stealing your surgical limelight. But as head of the PCT I can also tell you that being a GP in a place like this is a damn sight harder than it looks. I'd even go so far as to say that, in some ways, it's harder than vascular surgery."

Martin spit up the water he'd been swallowing and grabbed for a napkin. "Don't strain credulity, Chris."

"No, I mean it. Oh I won't argue that you have to have some solid technical skills to be a vascular surgeon, especially as one as good as you. But patients came to you with obvious vascular issues; all you needed to do was fix them."

"Yes, and I might add, it was highly demanding work."

"I'm not suggesting it wasn't."

"As opposed to here, where I spend my time treating diarrhea and diaper rash. Any idiot straight out of medical school could do just as well."

Parsons shook his head. "I don't think so. You've made it look so easy that you've started to believe it _is_ easy."

"You won't convince me that diagnosing the common cold requires skills beyond those of a competent mother."

"I won't try," Parsons replied. "What's difficult is knowing when it's _not_ the common cold; when the hoofbeats are from a zebra and not a horse. Patients come to their GP with a list of symptoms. You have to ask the right questions, order the right tests, and then piece it all together, as you did the other night. We both know there are at least a hundred reasons for a woman to have abdominal pain – it took you to figure out the right one."

Martin waved aside the compliment. "It wasn't a complex diagnosis."

"Not for you, which is the point. Tell that to Owens. As crazy as it sounds, I think your skills are even better suited to being a GP than a surgeon."

"Oh, Chris, skip the flattery and the platitudes. You're merely looking for reasons to keep me here."

Parsons gave him a dark look. "That's not fair, Martin. I'm the one who found you the job at Imperial and, I might add, took some flak when you backed out of it."

Martin had the sense to look contrite. "Sorry. I didn't mean that."

Parsons waved him off. "That's neither here nor there. Martin, you're at a decision point. What you did the other night showed you can still be a surgeon, if you still want to be. But do you? And if so, why? To prove that you still can, to recapture prestige in the eyes of the Edith Montgomerys of the world, or because it's what you really want to do with the rest of your life. Because, if it's not the last, I doubt you'll ever be satisfied – personally or professionally."

Before Martin could reply, he heard Louisa's feet on the stairs and, a few seconds later, she stepped into the room. Both men immediately rose to their feet.

"Chris!" She exchanged a quick hug with him. "Fancy seeing you here."

"He stopped by to, um, chat," Martin explained.

"Actually to talk about the GP opening in Portwenn," Parsons added, giving her a wink.

"What?" she exclaimed in surprise.

"Owens is leaving," Martin said. "I'll explain later."

"Well, I know how precious time together is when you have an infant," Parsons said, taking a final sip of his wine before setting down the glass.

"It's all right," Louisa said. "Please stay."

He shook his head. "No, I'll give you some time alone. And, besides, I have a long drive back." He took a few steps toward the door. "Martin, Owens has given his notice. I need to know whether I should start a search for his replacement . . . or whether I've already found him."

The minute the door had closed behind Parsons, Lousia turned to Martin. "What did he mean by that last?"

"He's asking whether I want to go back to being the GP here."

"You? Stay here?" Her eyes widened. "Is that what you want?"

Martin sunk into the sofa and, a moment later, she knelt on the floor in front of him.

"I . . . don't know, Louisa," he said, looking down at her. "Would it make you happy if I were to stay . . . here in Portwenn, as the GP?"

"Martin, you can't stay here – or anywhere else - to make _me_ happy. _You _have to be happy."

"Why?"

"Why what?"

"Louisa, everything I've done since I've been here has been what I wanted, or at least what I thought I wanted. And none of it has worked out very well, has it? So what's wrong with my finally doing something simply because _you_ want it?"

"Well, because I . . ." Her brow furled. "Because it's . . . I don't know, Martin. Maybe it's because I know you'll end up resenting me."

"I'd never!"

"Yes, you would. I'd be the one keeping you from being a surgeon in London. And I'd have to live with knowing that I'd made you unhappy."

"You won't make me unhappy," Martin replied automatically. Yet, even as he spoke, he cringed at the reminder of the words spoken on their wedding day . . . the day he'd told Louisa that she wouldn't make him happy. He'd been wrong then and had spent the past year ruminating on that failure. He didn't intend to make the same mistake again.

And, yet, on one count, she was right. If he agreed to stay in Portwenn, any chance of a surgical career was gone. He might not resent her today, but how would he feel tomorrow or next month or ten years from now when he was still here, still diagnosing diarrhea and the common cold?

For Louisa, Portwenn was home. Unlike her, he'd always be an outsider – never fit in, never be one of them. The village might accept him as their doctor but never as one of their own. And yet, much as he hated to admit it, he'd come to care not only for them, but about them. If asked, he'd ascribe it to a medical obligation, but inside he knew it was more than that.

He'd seen it in Truro. As a consultant, he'd attended to the medical needs of his patients as conscientiously as he had in Portwenn. As Parsons had said, he'd asked the right questions, performed the right examinations, made the right diagnoses, and prescribed the right treatment. And, yet, something was missing. As painful as it was for him to admit it, he'd found himself actually missing the monotony and drudgery interspersed with the occasional crazy emergencies and challenging diagnoses that marked his GP practice in Portwenn.

He was good at it, and these bodmin villagers actually needed him. Parsons was right – dozens of surgeons could take his place in London; how many GPs could take his place in Portwenn? Apparently not Owens.

He knew what he needed to do. No, he corrected himself, what _he_ wanted to do. He cupped a hand under Louisa's chin and tilted her head until their eyes locked.

"Louisa. I know what will make me . . . happy. What I need to know is whether that will make you happy as well—"

The jingling of the house phone interrupted his conversation. He gave Louisa a look that implored her to ignore it.

"It could be someone from school," she said, reaching for the receiver. "I'm the head teacher; I have to take it. Hello. " She listened for a minute then looked at him with an expression of resignation. "Calm down. Try not to panic. Dr. Ellingham is right here. I'm sure he can help you."

Martin frowned as she handed him the phone, her palm covering the mouthpiece. "Mrs. Bowles," she whispered. "Her son Joe swallowed a Lego."

"What?"

"You know, those little plastic toys—"

"I know what a Lego is."

"She's in a panic, Martin. Please talk to her."

"Oh, for God's sake." He grabbed the phone out of her hand. "Dr. Ellingham here," he barked.

"Thank goodness I reached you, Doctor. Joe was playing with his Legos and he put one into his mouth and then he—"

"Calm down, Mrs. Bowles. Is Joe able to breathe? Is he choking?"

"No, I told you. He swallowed it."

Martin looked at Louisa and shook his head in frustration then turned his attention back to the phone. "How old is the boy?"

"Four," the mother replied.

"All right, Mrs. Bowles. How large was the piece he swallowed?"

As the mother answered, Martin held his hand over the receiver. "I'm sorry, Louisa."

"It's all right, Martin."

He gave her an apologetic look, as he had so many times before. He had to answer the call, even at moments like this when it was the very last thing he wanted to do. It was his duty as a doctor, as the GP of this village. He had to answer even when it made Louisa unhappy.

He always had to answer the call. And always would.

_~The End~_

End Note: The comment Parsons makes to DM about zebras and horses refers to a saying in medical school: "When you hear hoofbeats, think horses, not zebras." In other words, most of the time, the diagnosis is the obvious one. Medical students spend so much time learning about exotic diseases (zebras) that they sometimes forget that most patients presenting with common symptoms have a common illness (horses). The point Parsons is making is that DM is good at knowing when symptoms are _not_ due to a common illness – when the hoofbeats actually are those of a zebra.

**Author's Note: My sincere thanks to each and every one of you who took the time to comment on my story; feedback is always so welcome and so encouraging. Also, a shout out to my beta, robspace54. Not only did he make suggestions that greatly improved my story, but he provided some excellent info on surgery for a ruptured ectopic that made that scene much more medically accurate. See you all 'round Portwenn!**


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